Link Between Apathy and Dementia

Older memory clinic patients with apathy have a 2-times higher risk for developing dementia, according to new research published online in JAMA Psychiatry.

These findings arose from a systematic review and meta-analysis of 7365 participants enrolled in 16 studies, which were identified using Medline, Embase, and PsychINFO databases.

Of the 7365 participants, 7299 had available data on apathy status. A total of 2 studies in the analysis included patients with subjective cognitive concerns, 1 examined patients with cognitive impairment without dementia, and 2 evaluated populations with and without cognitive impairment. The remaining 11 studies assessed patients with mild cognitive impairment

Primary outcomes included pooled crude risk ratios, maximally adjusted reported hazard ratios (HRs), and odds ratios (ORs), determined via DerSimonian-Laird random effects models.

Results showed that 1470 (20.1%) participants had apathy. The combined risk ratio of dementia for patients with apathy was 1.81, the HR was 2.39, and the OR was 17.14 for patients in the 12 studies that used validated definitions of apathy.

The observed association between apathy and dementia likely weakened with increasing follow-up time, age, and cognitive impairment, according to subgroup analyses, meta-regression, and individual study results.

The researchers noted that 95% of heterogeneity in mild cognitive impairment was explained by meta-regression adjusting for apathy definition.

“Apathy deserves more attention as a relevant, cheap, noninvasive, and easily measurable marker of increased risk of incident dementia with high clinical relevance, particularly because these vulnerable patients may forgo health care,” the researchers concluded.

—Christina Vogt

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