Apathy in multiple sclerosis: a validation study of the apathy evaluation scale

Area of Science:

• Neuroscience
• Clinical Psychology
• Neurology

Background:

• Apathy, a lack of motivation, affects cognitive, emotional, and behavioral domains.
• Apathy is increasingly recognized as a common symptom in multiple sclerosis (MS).
• Standardized scales like the Apathy Evaluation Scale (AES) are used to assess apathy.

Purpose of the Study:

• To evaluate the applicability and clinical-metric properties of the AES in MS patients.
• To assess the agreement between patient and caregiver evaluations of apathy.
• To determine the reliability and validity of the AES self-report version (AES-S) in MS.

Main Methods:

• Seventy non-demented MS patients were clinically and neuropsychologically assessed.
• Patients completed the self-report version of the Apathy Evaluation Scale (AES-S).
• Internal consistency, factorial analysis, convergent/discriminant validity, and ROC analysis were performed.

Main Results:

• AES-S demonstrated good internal consistency (Cronbach's alpha, α=0.87) and was easy to administer.
• Factorial analysis revealed three dimensions: cognitive, general apathy, and behavioral-emotional aspects.
• A cutoff score of >35.5 on AES-S identified clinically significant apathy with 88% sensitivity and 72% specificity, present in 35.7% of patients.
• Total AES score correlated with cognitive dysfunction and severity of frontal executive deficits.

Conclusions:

• The AES-S is a practical and dependable instrument for assessing apathy in non-demented MS patients.
• Apathy is prevalent in non-demented MS and linked to worse cognitive function, making AES-S clinically significant.
• AES-S aids in understanding and managing apathy-related cognitive impairments in MS.