Apathy is a possible sign of dementia

It is known that depression in older people may be associated to some extent with the development of cognitive impairment. According to a new study by Dutch and British scientists, apathy is a more accurate indicator. An article about it has been published in the Journal of Neurology, Neurosurgery & Psychiatry.

To estimate the risk of dementia in patients, the researchers often use so-called scales of depression, which actually do not distinguish between depression and apathy, according to scientists from Cambridge University, King's College London, Oxford (UK) and the University of Nijmegen (Netherlands). In their new study, the authors first studied the correlation between depression, apathy, and dementia in people with cerebral microangiopathy - lesions of small brain vessels. This disease is a frequent cause of dementia.

They analyzed data from two independent patient groups, the UK and the Netherlands. The total number of participants is 450. In both groups, it was found that people with initially high levels of apathy, as well as with a tendency to increase the level of this disorder were at high risk of dementia. On the contrary, depression had no effect on the development of the disease. In the British cohort, 20% of the participants had dementia, in the Dutch cohort 11% had dementia. These participants had apathy, but the depression was at the same level as in patients without dementia.

The relationship between apathy and dementia still exists after other known risk factors such as age, education and cognitive skills were considered.

Apathy is defined as a disorder of purposeful behavior characterized by feelings of indifference and lack of motivation. Apathy, like depression, is a common psychoneurological symptom of cerebral microangiopathy. Although there are some similarities between these two symptoms, they are different disorders. MRI scans show that it is apathy, but not depression, that is associated with white matter lesions in the brain, affecting the likelihood of cognitive impairment.

"This means that apathy is not a risk factor for dementia, it is rather a sign of white matter network damage. A better understanding of these relationships is essential in the diagnosis and treatment of patients," says neurobiologist Jonathan Tay, lead author of the study.

July 15, 2020, 10:25 a.m.

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