Apathy in dementia: relations with depression, functional competence, and quality of life

This study set out to clarify the association of apathy and depression in dementia as well as apathy's association with basic (ADLs) and instrumental (IADLs) activities of daily living and quality of life. 68 outpatients with mild dementia were assessed on apathy, depression, global cognition, traditional ADLs/IADLs, complex daily living activities requiring intact executive functioning (DAD: Disability Assessment for Dementia Scale), and quality of life. The sample was stratified into high and low global cognition groups and compared. While no relationship was found between scores on apathy and depression in the high cognition group, there was a significant relationship between apathy and depression in the low cognition group. Further, high and low cognition groups differed in the relationship between apathy and ability to perform basic and complex activities of daily living. Specifically, in the high cognition group, increased apathy was correlated with diminished ability to perform traditional IADLs as well as those activities requiring intact executive functioning (i.e., DAD). In the low cognition group, increased apathy was associated with poor performance on traditional ADLs and IADLs, but was not related to performance on independent daily activities demanding good executive functioning. Finally, increased apathy was significantly associated with worse quality of life, but this held for the high cognition group only, suggesting that dementia patients with better cognition have insight into their deficits and, perhaps, experience poor quality of life as a result.