an article of Ainara Castaños
Neuropsychologist at
The apathyrelatively common in elderly people, is a persistent motivation deficit, characterized by the loss of interest in others, in oneself and in the environment. The person with apathy does not feel the impulse to carry out activities that previously gave them satisfaction, lacks initiative, is not able to set goals, has problems with cognitive performance and manifests little affective response.
This very significant indifference to pleasant or unpleasant stimuli is known as ‘emotional flattening‘. The apathetic person has lost or has no interest in carrying out activities, lack of motivation to start new things, has difficulty engaging in conversation or doing tasks, and is habitually indifferent.
apathy and depression
It is important differentiate depression and apathy. In apathy there is a loss of emotional response: nothing attracts your attention. In depression, the person may seem apathetic because they show no interest or initiative, but there is sadness, a tendency to cry, anguish, a feeling of helplessness, and feelings of guilt. Sadness, helplessness, the feeling of loneliness, etc. they are present in depression, but absent in apathy.
The apathy can be a symptom of depression, but not all depressives are apathetic and not all apathetic suffer from depression. The sad mood, symptoms such as feelings of guilt, pessimism, self-criticism, hopelessness, and symptoms such as the inability to experience pleasure, may be present in depression and absent in apathy.
triggers
Apathy arises as a consequence of neurochemical or structural abnormalities in our brain and can manifest itself with its own clinical criteria or as a symptom within other syndromes (dementia, depression, psychiatric disorders, Parkinson’s…).
It is rare that apathy manifests itself in isolation. Some cases may require drug treatment, so the differential diagnosis with depression and knowing the type of neurodegenerative disease that causes it is essential.
apathy and dementia
In the context of the dementias, apathy is a common symptom. in disease of Alzheimer’sas the deterioration progresses, has a high prevalence and is also very common in frontotemporal dementias. It is important to address it, since it can cause the disease to evolve more quickly, being a marker of greater severity, worse clinical management, and worse prognosis.
Recommendations against apathy in the elderly
- stimulate the participation in activities pleasant. If you know of an activity that was previously enjoyable and easy to do, help him start it and let him continue. Do not forget that it never leaves him to do anything, so things should be proposed and even guided to the beginning of the activity (but without forcing).
- encourage their social relationships and the connection with the environment.
- Avoid doing continuous comments about his lack of activity and criticize him for his loss of interest and initiative.
- If you start a task and don’t finish it, not criticize him.
- congratulate you for what he has done and even just for trying.
- ask your collaboration in some tasks but without getting nervous. The level of demand should start very low and gradually increase until you reach the level of activity that is best tolerated.
- No judge for his lack of affection, for his insouciance in the face of problems, etc. The person is not to blame, it is the disease that prevents him from being like before.