Pharmacological and Nonpharmacological Treatment for Apathy in Alzheimer Disease : A systematic review across modalities.

1 First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece. 2 Department of Psychosis Studies, Institute of Psychiatry, King's College, London, United Kingdom. 3 Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA.

Journal of geriatric psychiatry and neurology. 2017;(1):26-49

Abstract

OBJECTIVE Apathy is one of the most frequent neuropsychiatric symptoms encountered in Alzheimer disease (AD). Early diagnosis and timely treatment of apathy in AD seem to be of great importance, since apathy has been associated with poor disease outcome, reduced daily functioning, and caregiver distress. DESIGN Within this context, we conducted an extensive electronic search from the databases included in the National Library of Medicine as well as PsychInfo and Google Scholar for studies that have investigated the effect of pharmacological and nonpharmacological treatments of apathy in AD. RESULTS Acetylcholinesterase inhibitors, gingko biloba, methylphenidate, and a variety of nonpharmacological interventions were found to be successful in reducing apathy in patients with AD. Methodological heterogeneity of the studies and the small amount of studies where apathy was a primary outcome measure are limiting factors to evaluate for group effects. CONCLUSION Treatment of apathy in AD is a complicated and an underexplored field. Standardized and systematic efforts primarily focused on the study of apathy in AD may establish a benefit from individualized treatment for specific disease groups that would stem from a combination of both pharmacological and nonpharmacological interventions.

Methodological quality

Publication Type : Review

Metadata