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Apathy in persons with neurocognitive disorders: Moving the field forward
Jennifer R Gatchel1, Masud Husain2, Henry Brodaty3
1Massachusetts General Hospital, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA.
International Psychogeriatrics
|July 16, 2026
Summary
Apathy in neurocognitive disorders (NCDs) significantly impacts patients and carers. This white paper addresses knowledge gaps in apathy diagnosis, biomarkers, and treatments, recommending research and policy priorities for better care.
Area of Science:
- Gerontology
- Neuroscience
- Psychiatry
Background:
- Apathy is a prevalent and impactful syndrome in neurocognitive disorders (NCDs), leading to reduced functioning and poorer outcomes.
- Despite its clinical significance, substantial knowledge gaps hinder accurate recognition and effective management of apathy in NCDs.
Purpose of the Study:
- To provide a comprehensive overview of current knowledge on apathy in NCDs, including nomenclature, biomarkers, treatments, and prevention.
- To identify critical gaps in research and clinical practice to inform global priorities and policy development.
Main Methods:
- Convening a multidisciplinary Apathy Task Force by the International Psychogeriatric Association (IPA).
- Conducting structured discussions informed by literature review during IPA Congress meetings.
- Synthesizing insights across clinical, biological, and care domains.
Main Results:
- Apathy is highly prevalent in NCDs with significant functional, emotional, and societal impact.
- Clinical identification remains challenging despite refined diagnostic criteria; assessment tools lack consistent application.
- Neuroimaging suggests fronto-subcortical network involvement, but peripheral biomarkers are lacking.
- Non-pharmacological interventions are central to management, though pharmacological and neuromodulatory options show promise.
Conclusions:
- There are opportunities to improve apathy diagnosis, deepen mechanistic understanding, and develop targeted treatments.
- Key priorities include increasing awareness, integrating apathy into dementia strategies, and advancing biomarker and intervention development aligned with current criteria.
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