Measuring apathy in people with neurodegenerative conditions: one size does not fit all
11 December 2014
Apathy (or demotivation) is a distinct lack of motivation to plan, do and experience happy or sad emotions. It is something experienced by many people. However, it can also occur as a symptom in different neurodegenerative disorders.
Apathy is distressing for both patients and carers, which is why it is important for clinicians to know how to best identify it when it occurs as a symptom. This identification can help both patients and carers understand and, therefore, deal with apathy.
There are many different ways of identifying apathy, but it can be difficult to know which method is the best for measuring it.
As a part of his PhD, Anne Rowling Clinic, Psychology and Alzheimer Scotland Dementia Research Centre student Ratko Radakovic conducted a review of the quality of existing studies that use different apathy measurement methods. The review thoroughly examined how effective each measurement was at identifying apathy in different neurodegenerative conditions.
Ratko found that the studies that were included in this review had some methodological flaws, reducing the credibility of some apathy measurements. Additionally, some of the most commonly used methods for clinical and research assessment of apathy might not be as robustly designed as originally thought.
Overall Ratko’s findings showed that, while for some conditions such as Parkinson’s and Alzheimer’s disease, there are quite good methods for assessing apathy, in others these are distinctly lacking, such as Huntington’s Disease and motor neurone disease. If future validation studies were conducted with these flaws corrected, the same apathy measurements may prove to be more effective.
This work, which was published recently, makes recommendations for which scales to use in assessing apathy based on disease. The article points out the need for general apathy measurement methods that can be used in all neurodegenerative conditions.
The next stage for Ratko’s research is to explore a new apathy scale that looks to measure different types of apathy in neurodegenerative conditions. He hopes that by identifying different types of apathy we can help to reduce its associated negative effects, on both the patients and their caregivers.
Ratko Radakovic, Catherine Harley, Sharon Abrahams and John M. Starr. A systematic review of the validity and reliability of apathy scales in neurodegenerative conditions. International Psychogeriatrics, doi:10.1017/S1041610214002221.