Movement Control and Neuroplasticity Research Group, Tervuursevest 101, 3001, Louvain, Belgium.
IRCCS San Camillo Hospital, Via Alberoni 70, 30126, Venice, Italy.
Neurol Sci. 2024 Apr;45(4):1343-1376. doi: 10.1007/s10072-023-07197-7. Epub 2023 Nov 28.
The aim of this review is to provide an overview on prevalence and clinical tools for the diagnosis of apathy, as well as on neurophysiological and neuroimaging findings obtained from studies in patients with apathy in different forms of dementia, including Alzheimer's disease (AD), vascular (VaD) and mixed dementia, frontotemporal dementia (FTD), and Parkinson's disease dementia (PDD).
Randomized controlled trials, non-randomized controlled trials, controlled before-after studies, and interrupted time series from four databases (WebOfScience, Scopus, Pubmed, and PsycINFO) addressing apathy in adults or older people aged over 65 years of age affected by dementia were included.
The prevalence of apathy was 26-82% for AD, 28.6-91.7 for VaD, 29-97.5% in PDD, and 54.8-88.0 in FTD. The assessment of apathy was not consistent in the reviewed studies. Methylphenidate was the most successful pharmacological treatment for apathy. Neurobiological studies highlighted the relationship between both structural and functional brain areas and the presence or severity of apathy.
Apathy is a very common disorder in all types of dementia, although it is often underdiagnosed and undertreated. Further studies are needed to investigate its diagnosis and management. A consensus on the different evaluation scales should be achieved.
本综述旨在概述冷漠的患病率和临床诊断工具，以及不同类型痴呆症（包括阿尔茨海默病 [AD]、血管性痴呆 [VaD] 和混合性痴呆、额颞叶痴呆 [FTD] 和帕金森病痴呆 [PDD]）患者冷漠的神经生理学和神经影像学研究结果。
纳入了来自四个数据库（WebOfScience、Scopus、Pubmed 和 PsycINFO）的针对成年人或 65 岁以上患有痴呆症的老年人冷漠问题的随机对照试验、非随机对照试验、对照前后研究和间断时间序列研究。
AD 的冷漠患病率为 26-82%，VaD 为 28.6-91.7%，PDD 为 29-97.5%，FTD 为 54.8-88.0%。在综述研究中，冷漠的评估并不一致。哌醋甲酯是治疗冷漠最成功的药物。神经生物学研究强调了结构和功能脑区与冷漠的存在或严重程度之间的关系。
冷漠是所有类型痴呆症中非常常见的疾病，但往往被漏诊和治疗不足。需要进一步研究来探讨其诊断和管理。应就不同的评估量表达成共识。
