Apathy: a common psychiatric syndrome in the elderly

Apathy, or a lack of motivation, has been increasingly recognized as a distinct psychiatric syndrome. Apathy is primarily a dysfunction of the frontal-subcortical circuit and is associated with various neuropsychiatric disorders including Alzheimer's disease. Apathy is associated with a number of adverse outcomes, including apparent cognitive impairment, decreased daily function, poor insight into one's own functional and cognitive impairment, and poor outcome from rehabilitation treatment. Furthermore, the degree of caregiver's burden in these patients is significant. This article reviews the definition of apathy, prevalence and associated adverse outcomes, causation, the approach to patients with apathy, and available treatment options with particular attention to studies conducted in a nursing home setting. The purpose of this article is to increase the recognition of apathy by physicians working in the nursing home.