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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2005 Aug;76(8):1070–1074. doi: 10.1136/jnnp.2004.052795

On the overlap between apathy and depression in dementia

S Starkstein 1, L Ingram 1, M Garau 1, R Mizrahi 1
PMCID: PMC1739766  PMID: 16024880

Abstract

Background: Whereas apathy is increasingly recognised as a frequent abnormal behaviour in dementia, its overlap with depression remains poorly understood.

Aims: To assess the psychometric characteristics of a structured interview for apathy, and to examine the overlap between apathy and depression in dementia.

Methods: A total of 150 patients with Alzheimer's disease (AD) underwent a comprehensive psychiatric and cognitive assessment.

Results: Twelve per cent of the sample met criteria for both apathy and depression, 7% met criteria for apathy only, and 31% met criteria for depression only. Apathy (but not depression) was significantly associated with more severe cognitive deficits. Apathy and anxiety scores accounted for 65% of the variance of depression scores in dementia, and the diagnosis of apathy had a minor impact on the rating of severity of depression.

Conclusions: The Structured Interview for Apathy demonstrated adequate psychometric characteristics. Using a novel structured interview for apathy in AD we demonstrated that whereas the construct of depression primarily consists of symptom clusters of apathy and anxiety, apathy is a behavioural dimension independent of depression.

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