A Novel Rating Scale for the Measurement of Apathy in Institutionalized Persons with Dementia: The APADEM-NH

Agüera-Ortíz, Luis; Gil-Ruiz, Nuria; Cruz-Orduña, Isabel; Ramos-García, Isabel; Osorio, Ricardo S.; Valentí-Soler, Meritxell; Olazarán-Rodríguez, J; Dobato-Ayuso, José L.; Lanctôt, Krista L.; Martinez‐Martín, Pablo

doi:10.1016/j.jagp.2013.01.079

Cited by 20 publications

(19 citation statements)

References 39 publications

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“…Nevertheless, there is still a lack of objective tools to evaluate the different subtypes, and many methods typically assess apathy as a non‐dimensional concept (Radakovic et al, ). The only established apathy measures following a multidimensional apathetic structure are the Lille Apathy Rating Scale (LARS) (Sockeel et al, ; García‐Ramos et al, ), the Apathy Scale for Institutionalized Patients with Dementia Nursing Home version (APADEM‐NH) (Agüera‐Ortiz et al, ), and the Apathy Inventory (Robert et al, ). The latter is a very short questionnaire that includes only one item per dimension.…”

Section: Introductionmentioning

confidence: 99%

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Fernández‐Matarrubia

Matías‐Guiu

Cabrera‐Martín

et al. 2017

Int J Geriat Psychiatry

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Objectives: Apathy is one of the most common and disabling syndromes of dementia. Clinical apathy expression and neuroanatomical basis of apathy seem to differ between behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD), although evidence is scarce and poorly understood. Our main purposes were to compare the clinical apathy profile from patients with bvFTD and AD and analyze the relationship between apathy and brain metabolism measured using positron emission tomography imaging with 18 F fluorodeoxyglucose (FDG-PET). Methods: Forty-two bvFTD, 42 AD, and 30 healthy volunteers without cognitive or behavioral complaints were included. Apathy was defined using Robert's 2009 diagnostic criteria, and specific apathy characteristics were assessed with the Lille Apathy Rating Scale. All participants underwent FDG-PET brain scan to provide data for voxel-based morphometric analysis. Results: Multivariate analysis showed that subjects affected by bvFTD displayed greater impairment of emotional apathy and self-awareness in comparison with AD sample. Additionally, FDG-PET imaging analyses revealed that apathy was associated with different neuroanatomical substrates in each dementia group: left lateral prefrontal, medial frontal/anterior cingulate, lateral orbitofrontal and anterior insular cortices in bvFTD, and right anterior cingulate in AD. Conclusions: These results support that apathy is a complex syndrome, with different clinical expressions across different pathological conditions. Those differences in qualitative aspects of apathy seem to be associated with differences in the damage sites, as shown by our FDG-PET imaging analysis. Our findings provide a better knowledge about pathophysiology of apathy in dementia, which could have practical implications for therapeutic management.

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Section: Introductionmentioning

confidence: 99%

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Fernández‐Matarrubia

Matías‐Guiu

Cabrera‐Martín

et al. 2017

Int J Geriat Psychiatry

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“…Possible AD was diagnosed when AD-atypical cognitive manifestations were present in patients not fulfilling other etiological definitions and also when the clinical or paraclinical information was incomplete (e.g., due to lack of neuroimaging study). (b) Presence of apathy assessed by the APADEM-NH Rating Scale (Aguera- Ortiz et al, 2013). These patients were included in the present study because CVD is frequently associated with AD in old age (Fotuhi et al, 2009), and this association could be particularly relevant for apathy (Fuh et al, 2005).…”

Section: Patientsmentioning

confidence: 99%

“…The score ranges from 0 (worst) to 30 (best cognition). • The APADEM-NH scale (Aguera- Ortiz et al, 2013). • Neuropsychiatric Inventory (NPI) (Cummings et al, 1994).…”

Section: Clinical Variablesmentioning

confidence: 99%

“…These criteria set a minimum time of 4 weeks that the symptoms should be present to allow diagnosis and the need of demonstrable functional handicaps related to them. Recently, the Apathy In Dementia-Nursing Home Version Scale (APADEM-NH) has been designed to measure apathy and its three dimensions in institutionalized patients across all the stages of neurodegenerative dementia (Aguera- Ortiz et al, 2013). Some rating scales have been proposed for the measurement of apathy, but not all instruments specifically address the different apathy domains or are useful in dementia, particularly in the most advanced stages (Lueken et al, 2007;Marin et al, 1991;Robert et al, 2002;Sockeel et al, 2006;Starkstein et al, 1992;Starkstein et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

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Structural correlates of apathy in Alzheimer's disease: a multimodal MRI study

Agüera-Ortíz

Hernández-Tamames

Martinez‐Martín

et al. 2016

Int J Geriatr Psychiatry

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Objective Apathy is one of the most frequent symptoms of dementia, whose underlying neurobiology is not well understood. The objective was to analyze the correlations of apathy and its dimensions with gray and white matter damage in the brain of patients with advanced Alzheimer's disease (AD). Methods The setting of the study was at the Alzheimer Center Reina Sofía Foundation Research Unit. Participants include 37 nursing home patients with moderate to severe AD, 78.4% were women, and mean Standard Deviation (SD) age is 82.7 (5.8). Several measurements were taken: severe mini‐mental state examination and Global Deterioration Scale for cognitive and functional status, Neuropsychiatric Inventory for behavioral problems, and Apathy In Dementia‐Nursing Home Version Scale for apathy, including total score and subscores of emotional blunting, deficit of thinking, and cognitive inertia. 3T magnetic resonance imaging measures (voxel‐based morphometry, fluid‐attenuated inversion recovery, and diffusion tensor imaging) were also conducted. Results Moderate levels of apathy (mean Apathy In Dementia‐Nursing Home Version Scale: 31.1 ± 18.5) were found. Bilateral damage to the corpus callosum and internal capsule was associated with apathy severity (cluster size 2435, p < 0.0005, family‐wise error [FWE]‐corrected). A smaller and more anteriorly located region of the right internal capsule and corpus callosum was associated with higher emotional blunting (cluster size 334, p < 0.0005, FWE‐corrected). Ischemic damage in the right periventricular frontal region was associated with higher deficit of thinking (cluster size 3805, p < 0.005, FWE‐corrected). Conclusions Brain damage related to apathy may have different features in the advanced stages of AD and differs between the three apathy dimensions. Besides atrophy, brain connectivity and vascular lesions are relevant in the study of apathy, especially in the more severe stages of dementia. Further magnetic resonance imaging studies should include multimodal techniques. Copyright © 2016 John Wiley & Sons, Ltd.

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“…Aguera-Ortiz et al (12) change our focus to a novel rating for apathy: the Apathy in Institutionalized Persons with Dementia (APADEM-NH) scale. Using task force-proposed diagnostic criteria (13), this 26-item scale focuses on three apathy dimensions: deficit of thinking and self-generated behaviors, emotional blunting, and cognitive inertia.…”

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confidence: 99%

Beyond Memory: A Focus on the Other Neuropsychiatric Symptoms of Dementia

Peters

2015

The American Journal of Geriatric Psychiatry

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A Novel Rating Scale for the Measurement of Apathy in Institutionalized Persons with Dementia: The APADEM-NH

Cited by 20 publications

References 39 publications

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Different apathy clinical profile and neural correlates in behavioral variant frontotemporal dementia and Alzheimer's disease

Structural correlates of apathy in Alzheimer's disease: a multimodal MRI study

Beyond Memory: A Focus on the Other Neuropsychiatric Symptoms of Dementia

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