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Am J Alzheimers Dis Other Demen. 2019 Aug;34(5):337-343. doi: 10.1177/1533317519853466. Epub 2019 Jun 6.

Apathy and Disinhibition Related to Neuropathology in Amnestic Versus Behavioral Dementias.

Author information

1
1 Cognitive Neurology and Alzheimer's Disease Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
2
2 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
3
3 Department of Neuropathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
4
4 Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
5
5 Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Abstract

OBJECTIVES:

Investigating the frequency of apathy and disinhibition in patients clinically diagnosed with dementia of the Alzheimer type (DAT) or behavioral variant frontotemporal dementia (bvFTD) with neuropathology of either Alzheimer disease (AD) or frontotemporal lobar degeneration (FTLD).

METHODS:

Retrospective data from 887 cases were analyzed, and the frequencies of apathy and disinhibition were compared at baseline and longitudinally in 4 groups: DAT/AD, DAT/FTLD, bvFTD/FTLD, and bvFTD/AD.

RESULTS:

Apathy alone was more common in AD (33%) than FTLD (25%), and the combination of apathy and disinhibition was more common in FTLD (43%) than AD (14%; P < .0001). Over time, apathy became more frequent in AD with increasing dementia severity (33%-41%; P < .006).

CONCLUSIONS:

Alzheimer disease neuropathology had the closest association with the neuropsychiatric symptom of apathy, while FTLD was most associated with the combination of apathy and disinhibition. Over time, the frequency of those with apathy increased in both AD and FTLD neuropathology.

KEYWORDS:

Alzheimer’s disease; apathy; apolipoprotein E4; disinhibition; frontotemporal dementia; frontotemporal lobar degeneration; neuropsychiatric symptoms

PMID:
31170813
DOI:
10.1177/1533317519853466

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