Results from a new French study reveal that nearly half of newly diagnosed patients with mild Alzheimer's disease also suffer from apathy and depression. The study also showed that this group of patients received significantly more social assistance, was less autonomous and had a lower daily activity functioning score.

"Our study highlights the size of the problem of apathy and depression in newly diagnosed patients and shows what a devastating impact this can have", says Philippe Robert, Centre Mémoire de Ressources et de Recherche (CMRR) de Nice. We already know that these symptoms are the most frequent neuropsychiatric manifestations in Alzheimer's disease but this is the first time that the frequency has been observed using specific diagnostic criteria. We also know that people with apathy or depression and mild cognitive impairment have an increased risk of developing dementia, thus re-iterating the importance of intervention in helping delay the onset of Alzheimer's disease and the common neuropsychiatric conditions associated with it." He adds; "Early management and diagnosis of Alzheimer's disease using cognitive and neuropsychiatry signs might allow patients to remain independent for longer".

Apathy and depression are the most common neuropsychiatric features in Alzheimer's disease [1]. The risk of conversion of Alzheimer's disease is significantly higher for patients with Mild Cognitive Impairment (MCI) who show a lack of interest, a core apathetic symptom [2].

The epidemiology study set out, using set diagnostic criteria, to estimate the frequency of depressive disorders and apathy [3] in newly diagnosed Alzheimer's disease patients, and to describe the types of patients with these disorders. The cross-sectional, national French study involved 734 patients enrolled by 115 physicians.

The observed frequency of apathy and depression diagnosis was 41.6% and 47.9% respectively. Of the subjects involved, 32.4% of patients had both apathy and depression, 9.4% patients had apathy alone, 15.4% had depression alone and 42.9% neither had apathy nor depression.

The comparison study revealed that mild Alzheimer's disease patients with apathy received significantly more social assistance [Personalised Autonomy Allocation (APA)*] of 22.4% and 10.6% respectively (p<0.0001) than those without apathy. Similarly, mild Alzheimer's disease patients with depression received more social assistance than those without depression of 20.2% and 11.1% respectively (p<0.01).

The full results of the study will be presented at the Alzheimer's Association International Conference 2011 (AAIC 2011) in Paris, France.


*Personalised Autonomy Allocation (APA)[1]

The APA is a French national solidarity allowance designed to allow persons over the age of 60, with stable and regular residence in France that have lost autonomy, to obtain any aid needed to accomplish everyday tasks, whether they are living at home or in an establishment


[1] Benoit M, Andrieu S, Lechowski L, Gillette-Guyonnet S, Robert PH, Vellas B; REAL-FR group. Apathy and depression in Alzheimer's disease are associated with functional deficit and psychotropic prescription. Int J Geriatr Psychiatry (2008) 23 (4):409 - 14

[2] Robert PH, et al. Importance of lack of interest in patients with mild cognitive impairment. Am J Geriatri Psychiatry (2008); 16 (9): 770 - 776

[3] Mulin E, et al. Diagnostic criteria for apathy in clinical practice. Int J Geriatr Psychiatry (2011); 26 (2) : 158 - 165

[4] European Commission document on social security in France (2002)See here (last accessed July 2011)