Apathy and Its Nonpharmacological Treatment in Dementia

Apathy is the most common behavioral symptom in Alzheimer's disease. Apathy has been defined as a state characterized by simultaneous diminution in the overt behavioral, cognitive, and emotional concomitants of goal-directed behavior. In that sense, apathy refers to impairments in motor, cognitive, and emotional functions. To date, there is little empirical foundation for how these three levels interact in patients suffering from apathy. We describe here neurobiological foundations as well as clinical correlations between the severity of apathy and impairments in motor, cognitive, and emotional functions. Furthermore, we present a literature review of the nonpharmacological treatment options of apathy in dementia. We suggest that focusing on the motor, cognitive, and emotional aspects of apathy may help to implement successful treatment strategies. Multimodal, individualized approaches, including the use of physical activation and biography-based information to motivate dementia patients, seem to be of high relevance.