Apathy and Disinhibition Related to Neuropathology in Amnestic Versus Behavioral Dementias

Am J Alzheimers Dis Other Demen. 2019 Aug;34(5):337-343. doi: 10.1177/1533317519853466. Epub 2019 Jun 6.

Abstract

Objectives: Investigating the frequency of apathy and disinhibition in patients clinically diagnosed with dementia of the Alzheimer type (DAT) or behavioral variant frontotemporal dementia (bvFTD) with neuropathology of either Alzheimer disease (AD) or frontotemporal lobar degeneration (FTLD).

Methods: Retrospective data from 887 cases were analyzed, and the frequencies of apathy and disinhibition were compared at baseline and longitudinally in 4 groups: DAT/AD, DAT/FTLD, bvFTD/FTLD, and bvFTD/AD.

Results: Apathy alone was more common in AD (33%) than FTLD (25%), and the combination of apathy and disinhibition was more common in FTLD (43%) than AD (14%; P < .0001). Over time, apathy became more frequent in AD with increasing dementia severity (33%-41%; P < .006).

Conclusions: Alzheimer disease neuropathology had the closest association with the neuropsychiatric symptom of apathy, while FTLD was most associated with the combination of apathy and disinhibition. Over time, the frequency of those with apathy increased in both AD and FTLD neuropathology.

Keywords: Alzheimer’s disease; apathy; apolipoprotein E4; disinhibition; frontotemporal dementia; frontotemporal lobar degeneration; neuropsychiatric symptoms.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / pathology
  • Alzheimer Disease / physiopathology*
  • Apathy / physiology*
  • Disease Progression*
  • Female
  • Frontotemporal Dementia / pathology
  • Frontotemporal Dementia / physiopathology
  • Frontotemporal Lobar Degeneration / pathology
  • Frontotemporal Lobar Degeneration / physiopathology*
  • Humans
  • Inhibition, Psychological*
  • Longitudinal Studies
  • Male
  • Retrospective Studies
  • Severity of Illness Index