DOI: 10.1002/alz.077289 ISSN: 1552-5260

Alzheimer’s disease clinical management is determined by presence and severity of apathy

Antonio Oliveros‐Cid, Esther Sierrra Martinez, Lisbed Rondon Moreno, Antonio Oliveros‐Juste, Maria Angeles Cid Lopez, Sarai Garcia Hojas, Victoria Celorrio Lorente, Laura Cano Luque, Claudia Ovejas Catalan, Ana Chacon Carrasco
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



Apathy and agitation influence daily life and care in dementia. We believe it may also influence the diagnosis, especially in early stages. We intend to examine apathy among the symptoms and the relationship with the referral schedule and early diagnosis.


Outpatients referred for possible cognitive impairment included in a database of “apathy and cognitive impairment”. Clinical history, complete neuropsychological battery, MRI, MRI, laboratory, and treatment. In addition, some patients also undergo EEG, CSF and/or amyloid PET scans. Neuropsychological battery with special attention to the assessment of apathy and behavioral symptoms. Additionally, semi‐structured rating of the severity of apathy when patients were referred for the first time.


64 finally diagnosed as Alzheimer’s disease (CDR 0.5 to 2). Group differences according to the frequency and severity of apathy. Those who showed apathy or depression (Independently) as a predominant symptom when referred were more often treated with psychopharmacological therapy by Primary Physician or referred to Psychiatry, where AD was generally less considered. The level of apathy showed negative correlations with MMSE, for the same group (CDR) of patients. Significantly higher levels of apathy higher levels of apathy associated with intake of antidepressants and cognitive enhancers.


We observed different patterns of apathy in outpatients with MCI and patients with dementia; significant negative effect on early neurological assessment of those patients, and therefore deleterious effect on their opportunities for a correct approach in the early stages of the disease.

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