Non-pharmacological Management of Apathy in Dementia: a Systematic Review (Forum 2011)




Brodaty, Prof Henry
Burns, Ms Kim


Non-pharmacological Management of Apathy in Dementia: a Systematic Review Brodaty H1,2, Burns K1 1Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, NSW 2Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW Apathy is one of the most challenging and prevalent behavioural symptoms of dementia. It is associated with increased disability and caregiver frustration as well as reduced quality of life, rehabilitation outcomes and survival after nursing home admission. A literature search to set criteria yielded 56 non-pharmacological intervention studies with outcomes relevant to apathy in dementia. Studies were rated according to quality and categorised into 7 groups: exercise, music, multi-sensory, animals, special care programming, therapeutic activities and miscellaneous. Despite a lack of methodological rigor, it is apparent that nonpharmacological interventions have the potential to reduce apathy. This review indicates that therapeutic activities, particularly those provided individually, have the best available evidence for effectiveness in dementia. These include cognitive-communication stimulation, activities tailored to skill level and interests, kit-based activities, personalised audiotapes aiming to replicate the presence of caregiver and individual reminiscence. Recommendations are provided for quality research.