Diagnostic criteria for apathy in neurocognitive disorders

被引:101
作者
Miller, David S. [1 ]
Robert, Philippe [2 ,3 ,4 ]
Ereshefsky, Larry [5 ]
Adler, Lawrence [6 ]
Bateman, Daniel [7 ]
Cummings, Jeff [8 ,9 ]
DeKosky, Steven T. [10 ]
Fischer, Corinne E. [11 ,12 ]
Husain, Masud [13 ,14 ,15 ]
Ismail, Zahinoor [16 ]
Jaeger, Judith [17 ]
Lerner, Alan J. [18 ]
Li, Abby [19 ]
Lyketsos, Constantine G. [20 ]
Manera, Valeria [2 ,3 ]
Mintzer, Jacobo [21 ,22 ]
Moebius, Hans J. [23 ]
Mortby, Moyra [24 ]
Meulien, Didier [25 ]
Pollentier, Stephane [26 ]
Porsteinsson, Anton [27 ]
Rasmussen, Jill [28 ]
Rosenberg, Paul B. [20 ]
Ruthirakuhan, Myuri T. [19 ]
Sano, Mary [29 ]
Sarracini, Carla Zucchero [19 ]
Lanctot, Krista L. [19 ,30 ,31 ]
机构
[1] Signant Health, Blue Bell, PA USA
[2] Univ Cote dAzur, Cognit Behav Technol Lab, Nice, France
[3] Assoc Innovat Alzheimer, Nice, France
[4] Univ Nice, Ctr Memoire, Ctr Hosp, Nice, France
[5] Follow Mol, Marina Del Rey, CA USA
[6] Univ Maryland, Sch Med, Dept Psychiat, Baltimore, MD 21201 USA
[7] Indiana Univ Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA
[8] Univ Nevada, Sch Integrated Hlth Sci, Dept Brain Hlth, Las Vegas, NV USA
[9] Cleveland Clin, Lou Ruvo Ctr Brain Hlth, Las Vegas, NV USA
[10] Univ Florida, Dept Neurol, McKnight Brain Inst, Gainesville, FL USA
[11] Univ Toronto, Inst Med Sci, Toronto, ON, Canada
[12] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr Biomed Res, Toronto, ON, Canada
[13] Univ Oxford, Dept Expt Psychol, Oxford, England
[14] Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England
[15] Oxford NIHR Biomed Res Ctr, Oxford, England
[16] Univ Calgary, Hotchkiss Brain Inst, Calgary, AB, Canada
[17] CognitionMetrics, Wilmington, DE USA
[18] Case Western Reserve Univ, Univ Hosp, Cleveland, OH USA
[19] Sunnybrook Res Inst, Toronto, ON, Canada
[20] Johns Hopkins Univ, Baltimore, MD USA
[21] Med Univ South Carolina, Charleston, SC 29425 USA
[22] Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA
[23] Moebius Consult, Baar, Switzerland
[24] Univ New South Wales, UNSW Ageing Futures Inst, Sydney, NSW, Australia
[25] H Lundbeck & Co AS, Clin Res & Dev, Valby, Denmark
[26] Boehringer Ingelheim Pharma GmbH & Co KG, CNS Dis Res, Biberach, Germany
[27] Univ Rochester, Rochester, NY USA
[28] Psi Napse, Dorking, Surrey, England
[29] Icahn Sch Med Mt Sinai, Dept Psychiat, Alzheimer Dis Res Ctr, New York, NY USA
[30] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[31] Univ Toronto, Dept Pharmacol Toxicol, Toronto, ON, Canada
关键词
apathy; behavior; cognition; diagnostic criteria; emotion; motivation; neurocognitive disorder (NCD); neuropsychiatric symptoms (NPS); MILD COGNITIVE IMPAIRMENT; NURSING-HOME RESIDENTS; DISEASE RATING-SCALE; ALZHEIMERS-DISEASE; NEUROPSYCHIATRIC SYMPTOMS; PARKINSONS-DISEASE; FRONTOTEMPORAL DEMENTIA; NONPHARMACOLOGICAL TREATMENT; PSYCHOMETRIC PROPERTIES; AMYLOID BURDEN;
D O I
10.1002/alz.12358
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction Apathy is common in neurocognitive disorders (NCD) but NCD-specific diagnostic criteria are needed. Methods The International Society for CNS Clinical Trials Methodology Apathy Work Group convened an expert group and sought input from academia, health-care, industry, and regulatory bodies. A modified Delphi methodology was followed, and included an extensive literature review, two surveys, and two meetings at international conferences, culminating in a consensus meeting in 2019. Results The final criteria reached consensus with more than 80% agreement on all parts and included: limited to people with NCD; symptoms persistent or frequently recurrent over at least 4 weeks, a change from the patient's usual behavior, and including one of the following: diminished initiative, diminished interest, or diminished emotional expression/responsiveness; causing significant functional impairment and not exclusively explained by other etiologies. Discussion These criteria provide a framework for defining apathy as a unique clinical construct in NCD for diagnosis and further research.
引用
收藏
页码:1892 / 1904
页数:13
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