O2‐11‐06: THE COURSE OF APATHY IN PEOPLE WITH DEMENTIA

Apathy is one of the most common Neuropsychiatric Symptom (NPS) and is associated with worse clinical outcomes. Despite this apathy remains under-researched and the medical classification of apathy remains unclear, possibly due to the fact that apathy is commonly a comorbidity with depression making differentiation difficult. An analysis was conducted to examine the prevalence of apathy and the relationship between apathy, depression, dementia severity levels and other NPS. Meta-analysis of 4320 AD cases from 20 cohort studies was conducted to analyse the prevalence and course of apathy over time. Depression and apathy were defined based on item D (Depression/dysphoria) and G (Apathy/Indifference) respectively of the NPI scale. Of the 4320 subjects, 62% were female and 38% were male with a mean age 60 years and mean MMSE 19. Forty-nine percent presented with apathy. Cases of apathy without depressive symptoms accounted for 19%. In a subset of participants who were assessed longitudinally and had apathy at baseline, 42% had apathy at follow up with 58% having no apathy at follow up. Of cases without apathy at baseline 13% developed apathy at follow up. Apathy was common in this cohort, and persistent in nearly half of cases. Only a small proportion of people who had no apathy at baseline progressed to develop it. Apathy was commonly present alongside depression but there was also evidence of a distinct subset of patients who presented with apathy without depression. These findings support future analysis to examine the possible existence of distinct apathy subsyndromes and provide a basis for determining phenotypes in genetic and biomarker studies.