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Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version

Apathy is a common, disabling neuropsychiatric syndrome that occurs across many brain disorders and may be associated with diminished motivation in behavioural, cognitive, emotional and social domains. Assessment is complicated by the variability of symptoms across apathy domains and self‐report fro...

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Autores principales: Klar, Verena S., Ang, Yuen‐Siang, Lockwood, Patricia, Attaallah, Bahaaeddin, Dickson, Shannon, Drew, Daniel, Kienast, Annika, Maio, Maria R., Plant, Olivia, Slavkova, Elitsa, Toniolo, Sofia, Zambellas, Rhea, Irani, Sarosh R., Husain, Masud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290131/
https://www.ncbi.nlm.nih.gov/pubmed/34532963
http://dx.doi.org/10.1111/jnp.12262
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author Klar, Verena S.
Ang, Yuen‐Siang
Lockwood, Patricia
Attaallah, Bahaaeddin
Dickson, Shannon
Drew, Daniel
Kienast, Annika
Maio, Maria R.
Plant, Olivia
Slavkova, Elitsa
Toniolo, Sofia
Zambellas, Rhea
Irani, Sarosh R.
Husain, Masud
author_facet Klar, Verena S.
Ang, Yuen‐Siang
Lockwood, Patricia
Attaallah, Bahaaeddin
Dickson, Shannon
Drew, Daniel
Kienast, Annika
Maio, Maria R.
Plant, Olivia
Slavkova, Elitsa
Toniolo, Sofia
Zambellas, Rhea
Irani, Sarosh R.
Husain, Masud
author_sort Klar, Verena S.
collection PubMed
description Apathy is a common, disabling neuropsychiatric syndrome that occurs across many brain disorders and may be associated with diminished motivation in behavioural, cognitive, emotional and social domains. Assessment is complicated by the variability of symptoms across apathy domains and self‐report from patients, which can be misleading due to their lack of insight. Independent evaluation by clinicians also has limitations though if it has to be performed with limited time. Caregiver reports are a viable alternative, but current assessments for them either do not distinguish between different apathy domains or are interview‐based and take long to administer. In this study, we developed a brief caregiver questionnaire version of the recently developed Apathy Motivation Index (AMI), which is a self‐report tool. We confirmed three apathy factors in this new caregiver measure (AMI‐CG) that were also present in the AMI: Behavioural Activation, Emotional Sensitivity and Social Motivation. Furthermore, we validated the scores against more extensive caregiver interviews using the established Lillle apathy rating scale as well as patient self‐reports of apathy, measures of depression, anhedonia, cognition, activities of daily living and caregiver burden across four different neurological conditions: Parkinson's disease, Alzheimer's disease, subjective cognitive impairment and limbic encephalitis. The AMI‐CG showed good internal reliability, external validity and diagnostic accuracy. It also uncovered cases of social apathy overlooked by traditional instruments. Crucially, patients who under‐rated their apathy compared to informants were more likely to have difficulties performing everyday activities and to be a greater burden to caregivers. The findings provide evidence for a multidimensional conceptualization of apathy and an instrument for efficient detection of apathy based on caregiver reports for use in clinical practice.
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spelling pubmed-92901312022-07-20 Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version Klar, Verena S. Ang, Yuen‐Siang Lockwood, Patricia Attaallah, Bahaaeddin Dickson, Shannon Drew, Daniel Kienast, Annika Maio, Maria R. Plant, Olivia Slavkova, Elitsa Toniolo, Sofia Zambellas, Rhea Irani, Sarosh R. Husain, Masud J Neuropsychol Original Articles Apathy is a common, disabling neuropsychiatric syndrome that occurs across many brain disorders and may be associated with diminished motivation in behavioural, cognitive, emotional and social domains. Assessment is complicated by the variability of symptoms across apathy domains and self‐report from patients, which can be misleading due to their lack of insight. Independent evaluation by clinicians also has limitations though if it has to be performed with limited time. Caregiver reports are a viable alternative, but current assessments for them either do not distinguish between different apathy domains or are interview‐based and take long to administer. In this study, we developed a brief caregiver questionnaire version of the recently developed Apathy Motivation Index (AMI), which is a self‐report tool. We confirmed three apathy factors in this new caregiver measure (AMI‐CG) that were also present in the AMI: Behavioural Activation, Emotional Sensitivity and Social Motivation. Furthermore, we validated the scores against more extensive caregiver interviews using the established Lillle apathy rating scale as well as patient self‐reports of apathy, measures of depression, anhedonia, cognition, activities of daily living and caregiver burden across four different neurological conditions: Parkinson's disease, Alzheimer's disease, subjective cognitive impairment and limbic encephalitis. The AMI‐CG showed good internal reliability, external validity and diagnostic accuracy. It also uncovered cases of social apathy overlooked by traditional instruments. Crucially, patients who under‐rated their apathy compared to informants were more likely to have difficulties performing everyday activities and to be a greater burden to caregivers. The findings provide evidence for a multidimensional conceptualization of apathy and an instrument for efficient detection of apathy based on caregiver reports for use in clinical practice. John Wiley and Sons Inc. 2021-09-16 2022-03 /pmc/articles/PMC9290131/ /pubmed/34532963 http://dx.doi.org/10.1111/jnp.12262 Text en © 2021 The Authors. Journal of Neuropsychology published by John Wiley & Sons Ltd on behalf of British Psychological Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Klar, Verena S.
Ang, Yuen‐Siang
Lockwood, Patricia
Attaallah, Bahaaeddin
Dickson, Shannon
Drew, Daniel
Kienast, Annika
Maio, Maria R.
Plant, Olivia
Slavkova, Elitsa
Toniolo, Sofia
Zambellas, Rhea
Irani, Sarosh R.
Husain, Masud
Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version
title Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version
title_full Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version
title_fullStr Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version
title_full_unstemmed Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version
title_short Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version
title_sort assessment of apathy in neurological patients using the apathy motivation index caregiver version
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290131/
https://www.ncbi.nlm.nih.gov/pubmed/34532963
http://dx.doi.org/10.1111/jnp.12262
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