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Prevalence, neurobiology, and treatments for apathy in prodromal dementia

Published online by Cambridge University Press:  18 April 2017

Chelsea Sherman ,
Celina S. Liu ,
Nathan Herrmann  and
Krista L. Lanctôt
Chelsea Sherman
Affiliation:
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, Ontario, Canada
Celina S. Liu
Affiliation:
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, Ontario, Canada
Nathan Herrmann
Affiliation:
Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Krista L. Lanctôt*
Affiliation:
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program Sunnybrook Research Institute, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
*
Correspondence should be addressed to: Krista L. Lanctôt, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room FG08, Toronto, ON. M4N 3M5, Canada. Phone: +416-480-6100 ext. 2241; Fax: +416-480-6022. Email: Krista.Lanctot@sunnybrook.ca.
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Abstract

Background:

Apathy, characterized by diminished motivation, is a highly prevalent neuropsychiatric symptom in dementia. However, there is a substantial knowledge gap with regard to prevalence rates, neurobiological underpinnings, and effective treatments for apathy in pre-dementia states, including mild cognitive impairment (MCI) and mild behavioral impairment (MBI).

Methods:

We conducted a comprehensive literature search using MEDLINE, Embase, and PsycINFO databases to identify available research on apathy in prodromal dementia.

Results:

Apathy has consistently been detected in individuals with MCI with varying prevalence rates, and only recently has literature discussed the prevalence of apathy in MBI. Few pharmacological treatments have been utilized for apathy, with galantamine and risperidone showing mild reductions in apathetic behaviors. Non-pharmacological interventions in prodromal dementia are beginning to be explored and show promise, but few studies have replicated those results.

Discussion:

More comprehensive guidelines for diagnosing apathy and further research investigating neurobiological mechanisms of apathy in MCI and MBI are required in order to effectively treat apathetic patients in prodromal dementia.

Keywords

mild cognitive impairmentmild behavioral impairmentpre-dementia syndromesprodromal dementiaapathydecreased motivation
Type
Review Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 2: Mild Behavioral Impairment , February 2018 , pp. 177 - 184
Copyright
Copyright © International Psychogeriatric Association 2017 

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