Apathy could be an early sign of dementia

APATHY, not depression, could be an early warning sign of dementia, a study by the University of Cambridge has suggested.

Scientists found that individuals with higher baseline apathy, as well as those with increasing apathy over time, had a greater risk of dementia.

But neither baseline depression nor change in depression had any detectable influence on dementia risk, the study found.

The research suggests that the belief that depression is a risk factor for dementia may be because some depression scales used by clinicians and

researchers partially assess apathy. The

study, published in the Journal of Neurology, Neurosurgery and Psychiatry, is based on analysis of more than 450 patients in the UK and the Netherlands with cerebral small vessel disease (SVD) – the narrowing of small blood vessels inside the brain.

Apathy, defined as a reduction in “goal-directed behaviour”, is a common symptom in SVD, and is distinct from depression, another symptom.

SVD may occur in one in three elderly people and is the most common cause of vascular dementia.

Jonathan Tay, the lead author from Cambridge’s department of clinical neurosciences, said: “Individuals identified as having high apathy, or increas- ing apathy over time, could be sent for more detailed clinical examinations.”

Assessed for apathy, depression and dementia over several years, nearly 20 per cent of the UK cohort developed dementia, while 11 per cent in the Netherlands cohort did, likely due to the more severe burden of SVD in the UK cohort.

In both data sets, patients who later developed dementia showed higher apathy, but similar levels of depression, compared with patients who did not.

It is the first study to examine the relationships between apathy, depression and dementia in individuals with SVD, Cambridge University said.