[Loss of motivation in dependent elderly subjects]

Loss of motivation differs from a mood disorder. It belongs to the field of psychic regression and results in social dependency. The concept of psychic regression, initiated and driven by a motivation loss, requires a reassessment of the family links and of the patients-carers relationships. The relative part of conative depression, dysexecutive syndrome, and psychic regression is difficult to assess in old subjects on account of the complexity of the involved mechanisms (psychological aging, affective and relational history of the subject, family and environmental interactions). Lack of motivation and social dependency in old people result from a failure of the psychological mechanism of elaboration. We present a phenomenological point of view and advance some propositions for their prevention. Loss of motivation appears to be an acquired and dynamic process resulting from the psychological difficulties experienced by the individual due to the loss of autonomy and an increasing dependency which is not accepted although, paradoxically, searched for. This ambivalence results in loss of motivation and psychic regression which belongs to the non cognitive disorders of elderly people.