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EPDA - European Parkinsons Disease Association EPDA - European Parkinsons Disease Association EPDA - European Parkinsons Disease Association EPDA - European Parkinsons Disease Association EPDA - European Parkinsons Disease Association EPDA - European Parkinsons Disease Association EPDA - European Parkinsons Disease Association
EPDA - European Parkinsons Disease Association
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What causes apathy in Parkinson’s?

The exact cause of apathy in Parkinson’s is unclear but it is thought to be due to the chemical changes that occur in the basal ganglia, the area of the brain associated with a variety of functions including emotion and motor control.

Living with Parkinson’s may also make social contact more difficult because of reduced mobility and the ways in which communication can be affected; these factors may exacerbate any burgeoning feelings of apathy.

For a long time it was generally considered that apathy and depression go hand in hand, but a study in 2006 revealed that people with Parkinson’s do not have to have depression in order to experience apathy. The study1 compared 80 people with Parkinson's with 20 others with non-Parkinson's dystonia, and found a significantly higher severity and frequency of apathy in those with Parkinson's. 51% of participants with Parkinson's scored positive for apathy on the Marin Apathy Evaluation Scale2, compared with 20% of those with dystonia. Results also showed that although the rates of depression were the same for both groups, 28.8% of Parkinson’s participants experienced apathy with no depression compared with none of those with dystonia.

These results highlight the importance of screening for both apathy and depression to ensure correct diagnosis, and to avoid prescribing treatment for depression when it is not present.

Did you know?

Other disorders associated with the basal ganglia area of the brain include: Attention-deficit hyperactivity disorder (ADHD), Cerebral palsy, Obsessive-compulsive disorder (OCD), Tourette’s syndrome and stuttering.

 

Diagnosis

Diagnosis can be tricky in those with Parkinson’s, particularly as those people with feelings of apathy tend not to complain - by definition, they do not care about their disinterest and tend to do little to address the situation. As a result, it is often family and carers who act and seek help.

Apathy is usually diagnosed by asking about mood, motivation and other indications, and there are several recognised ‘evaluation scales’ - the Marin Apathy Evaluation Scale (as mentioned above), Beck Depression Inventory, and Centres for Epidemiologic Studies-Depression Scale, for example. These involve asking various questions designed to determine whether you are self-motivated or need to be told what to do, and whether you like to see tasks through or not. Responses are measured using a points system to see if apathy is present is not.

Important

Apathy can cause stress for carers and family and affects their quality of life, so it is necessary that they understand that apathy is a characteristic of Parkinson’s - not the patient being lazy or difficult.

 

References


  1. Disassociating Apathy and Depression in Parkinson’s Disease – Neurology 20063;67:33-38

  2. Marin Apathy Evaluation Scale
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