Is apathy a prodrome of dementia?

Many experts wonder if apathy is a prodrome of dementia. Apparently yes, according to a meta-analysis, and addressing apathy in patients with early signs of dementia might be helpful.

About half of demented patients develop apathy. To determine the prognostic implication of this feature before the onset of dementia, Dutch researchers conducted a meta-analysis of 16 longitudinal studies of patients with subjective cognitive concerns (SCC), mild cognitive impairment (MCI), cognitive impairment without dementia, and no cognitive impairment. Data synthesised came from 7,299 patients (median age, 72) followed prospectively for a median of 2.4 years.

At baseline, apathy, as defined by standardised scales, was present in 20% of subjects. The overall risk for developing dementia was approximately doubled in memory clinic patients who had apathy at baseline. The risk was doubled in patients with MCI and might have been considerably greater in those with SCC, but there were not enough patients in this category for a reliable estimate. Associations between apathy and dementia diminished with longer follow-up. The elevated risk was independent of comorbid depression.