How to Diagnose Apathy in Neurocognitive Disorders?
Alzheimer’s disease, a progressive neurodegenerative disorder, not only affects memory and cognitive functions but also takes a toll on emotions and motivation. Among the many behavioral changes associated with Alzheimer’s, apathy is one of the most common and challenging symptoms to manage.
Apathy, characterized by diminished motivation, reduced goal-directed behavior, and a lack of emotional responsiveness, is a common but often overlooked symptom in various neurocognitive disorders. This symptom can significantly impact the quality of life, not only for patients but also for their caregivers and families.
Our Academy’s YouTube video will aim to shed light on the nuanced process of diagnosing apathy in neurocognitive disorders: based on 2021 Consensus Diagnostic Criteria for Apathy in Neurocognitive Disorders.
2021 Consensus Diagnostic Criteria for Apathy in Neurocognitive Disorders:
DETAILED LECTURE FOR ACADEMY MEMBERS:
(1) APATHY IN PRE-DEMENTIA STATE:
- Apathy as a Neuropsychiatric Symptom (NPS) in Neurocognitive disorders (NCD).
- Why is Apathy emerging as a treatment target in NCD?
- Apathy in Pre-Dementia State.
- Mild Behavioral Impairment: ISTAART-AA developed research diagnostic criteria.
(2) APATHY: DIAGNOSTIC CRITERIA
- 2008 Diagnostic Criteria for Apathy in Alzheimer’s disease and other Neuropsychiatric Disorders.
- 2018 Proposed New Diagnostic Criteria for Apathy.
- 2021 Consensus Diagnostic Criteria for Apathy in Neurocognitive Disorders.
(3) RATING SCALES FOR APATHY
Compare 6 rating scales for apathy, in terms of:
- Type of scale
- Apathy domains
- Sensitivity to change
- Time frame of assessment
- Information source
- Specific validation in nursing home patients
(4) MECHANISM & BIOMARKERS
- Neuroimaging correlates of apathy.
- Comparing Pre-Dementia population with Alzheimer’s Dementia.
- Regional hypoperfusion and hypometabolism.
- Atrophy of the medial frontal regions.
- High-density deposition of neurofibrillary tangles.
- Neurotransmitters: Cholinergic, Serotonergic & Dopaminergic.
- Fluid biomarkers
(5) TREATMENT:
PHARMACOLOGICAL OPTIONS
Compare 9 medication classes for apathy treatment, in terms of:
- Recommended Treatment: First-Line?
- Medications with Questionable Response.
- Medications to Avoid?
(6) TREATMENT:
NON-PHARMACOLOGICAL OPTIONS
- Discuss available studies on non-pharmacological treatment options for apathy.
- Which non-pharmacological approach has the strongest evidence?
- Efficacy of neuromodulation for apathy treatment.
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This new Article Based Continuing Certification (ABCC) Pathway is an ongoing professional journal article-based assessment activity designed by ABPN (American Board of Psychiatry and Neurology) for physicians to meet their Continuing Certification program requirement.
In our journal club discussions, we are discussing these articles from this ABCC track in a clinically relevant fashion. This will help you answer the multiple-choice questions on ABPN’s website to get the credits for each article discussion.
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