Apathy in Dementia: Insights From Neuropsychiatric And Radiological Perspectives

Introduction: Apathy is a common neuropsychiatric symptom in all stages of dementia, significantly complicating patient management. This study examines the prevalence of apathy across Alzheimer’s Disease (AD), Lewy Body Dementia (LBD), Frontotemporal Dementia (FTD), Vascular Dementia (VD), and Mild Cognitive Impairment (MCI) and explores its associations with cognitive functions, neuropsychiatric symptoms, and magnetic resonance imaging (MRI) findings. Materials and Methods: This retrospective, cross-sectional study included 200 patients diagnosed with AD, LBD, FTD, VD, and MCI, along with 100 healthy controls (HC). Apathy was assessed using the Apathy Evaluation Scale. Depression and anxiety in patients were evaluated using the Geriatric Depression Scale and Geriatric Anxiety Scale, respectively. Cognitive function was measured with the Mini-Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination-Revised (ACE-R). MRI findings were analyzed using atrophy scales. Results: Apathy was significantly more prevalent in dementia and MCI patients compared to HC. However, there were no significant differences in apathy prevalence among dementia subtypes or MCI. Apathy showed no significant correlation with depression, anxiety, or cognitive performance. Notably, MRI analysis revealed a strong association between apathy and orbitofrontal sulcus atrophy. Conclusion: Apathy is a critical symptom in dementia, linked to orbitofrontal sulcus atrophy and presenting challenges in management. These findings emphasize the importance of integrating apathy assessments into clinical practice. Larger, longitudinal studies are needed to further clarify the pathophysiology and management of apathy in dementia.