Magazine article Clinical Psychiatry News

Music, Exercise, and More Visitors May Fight Apathy as Well as Drugs. (Alzheimer's Disease)

Magazine article Clinical Psychiatry News

Music, Exercise, and More Visitors May Fight Apathy as Well as Drugs. (Alzheimer's Disease)

Article excerpt

BALTIMORE -- Nonpharmacologic interventions are at least as effective as drugs in the treatment of apathy in Alzheimer's disease, Dr. Chiadi Onyike said at a meeting on Alzheimer's disease and other dementias sponsored by Johns Hopkins University.

Apathy is a common, distressing complication of Alzheimer's disease that clinicians should be careful not to confuse with depression. Apathy and depression respond to different interventions, stressed Dr. Onyike, who is a psychiatrist at Johns Hopkins.

Alzheimer's disease patients with apathy show none of the sadness, sense of worthlessness or hopelessness, tearfulness, or anxiety seen in patients with depression. Apathetic patients are not sad; rather they have diminished motivation, he said.

Apathy increases the dependence of a patient with Alzheimer's disease; it interferes with activities of daily living such as self-dressing and bathing as well as keeping the checkbook and finding one's way around the neighborhood.

As a result, apathy increases the burden on the caregiver while depriving the caregiver of rewarding interaction with the patient. Apathetic Alzheimer's patients fail to display any positive emotion toward their caregiver and even show no delight in the presence of their grandchildren, which can be demoralizing for the whole family

The clinician can screen for apathy by asking the caregiver whether the patient has lost interest in the surrounding world or in doing things or starting new activities. …

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