Negative symptoms in the elderly patient with dementia

Negative symptoms are a well-documented, intensively studied feature of schizophrenia. In recent years, however, increasing attention has been directed to the prominence of these symptoms in elderly patients suffering from dementia. Behavioral alterations such as avolition, apathy, social withdrawal and emotional disengagement appear to be commonly found in patients suffering from Alzheimer's disease. A consistent research finding is that negative symptoms in dementia cannot be solely accounted for by depression; they represent a separate symptomatic cluster. An area of ongoing investigation is the relationship of negative symptoms to the functional impairment of dementia. It has been hypothesized that negative symptoms may contribute to the functional impairment caused by cognitive deterioration. Recently, it was reported that negative symptoms in dementia are responsive to pharmacotherapy with an atypical antipsychotic agent. This treatment effect appeared to be independent of effects on positive symptoms. As dementia continues to be a major public health concern, the phenomenology of negative symptoms in the elderly and the treatment of these symptoms are likely to remain areas of active investigation.