There is currently no cure for dementia, so accurately predicting who develop dementia is vital to minimizing its impact. According to a new review, apathy may hold the key.

Dementia overwhelmingly impacts older adults. Although scientists know about some risk factors, predicting who will eventually develop dementia is challenging.  As people age, cognitive abilities tend to decline, and 5–20 percent of those over 65 years old will develop mild cognitive impairment.  Research has found that older adults with a mild cognitive impairment who visit memory clinics — centers dedicated to diagnosing memory problems — that most of these individuals’ memories will either return to normal levels of functioning or not deteriorate any further.  By studying memory clinic patients scientists are trying to understand the difference between patients whose memory function continues to deteriorate and those whose memory remains stable.  It seems that patient behavior might be a useful way to assess an individual who might be at risk of continued memory deterioration.

Apathy as an early warning sign

One behaviors that scientists are finding may be related to continued memory deterioration is apathy.  Apathy is defined as a loss of motivation, a lack of interest, and reduced emotional expression. If apathy is related to an increased chance of developing dementia, it might become a relatively easy way to identify increased risk — even in a short consultation.  Researchers have noted that apathy is a common feature of dementia, occurring in around half of the people with Alzheimer’s disease. To date, studying the role of apathy before dementia develops has received little attention.

Recently, researchers set out to see whether apathy could be an early marker for dementia. To do this, they dipped into the findings from previous studies and carried out a fresh analysis of the data.  The researchers assessed and collated data from 16 studies, including 7,365 patients (Their results were published in JAMA Psychiatry).  The study concluded that apathy was associated with approximately a twofold increased risk of dementia in memory clinic patients.  Researchers saw a particularly pronounced effect in younger, healthier individuals because it was easier to detect apathy in them.  Older people tend to withdraw for a range of reasons, such as physical or cognitive constraints, rather than apathy. When a younger individual becomes withdrawn, it is perhaps more unexpected, making it more obvious.

A new risk factor for dementia?

The authors of the study go on to suggest that apathy could be useful to doctors, by helping them gauge the potential risk of developing dementia, alongside standard clinical tests as the evaluation of apathy is a noninvasive, cheap, and easy to implement.  Much of the recent research on predicting dementia has focused on developing biologic markers for dementia risk, including MRI and the analysis of spinal fluid. Compared with these high-tech options, assessing apathy would be much quicker and more cost-effective.  As always, continued research is required to gather more detail on this relationship. The authors caution that it is important to remember that not every older adult with apathy will go on to develop dementia.  As the United States population ages, the early detection of dementia is more important than ever. Assessing an individual’s level of apathy might soon become a part of the clinician’s range of predictive tools.