%0 Journal Article
%T Cognitive Stimulation for Apathy in Probable Early-Stage Alzheimer's
%A Linda L. Buettner
%A Suzanne Fitzsimmons
%A Serdar Atav
%A Kaycee Sink
%J Journal of Aging Research
%D 2011
%I Hindawi Publishing Corporation
%R 10.4061/2011/480890
%X We studied changes in apathy among 77 community-dwelling older persons with mild memory loss in a randomized clinical trial comparing two nonpharmacological interventions over four weeks. The study used a pre-post design with randomization by site to avoid contamination and diffusion of effect. Interventions were offered twice weekly after baseline evaluations were completed. The treatment group received classroom style mentally stimulating activities (MSAs) while the control group received a structured early-stage social support (SS) group. The results showed that the MSA group had significantly lower levels of apathy ( ) and significantly lower symptoms of depression ( ). While both groups improved on quality of life, the MSA group was significantly better ( ) than the SS group. Executive function was not significantly different for the two groups at four weeks, but general cognition improved for the MSA group and declined slightly for the SS group which produced a significant posttest difference ( ). Recruitment and retention of SS group members was difficult in this project, especially in senior center locations, while this was not the case for the MSA group. The examination of the data at this four-week time point shows promising results that the MSA intervention may provide a much needed method of reducing apathy and depressive symptoms, while motivating participation and increasing quality of life. 1. Introduction Neuropsychiatric symptoms of dementia are common and associated with poor outcomes for patients and caregivers [1]. Apathy is the most common neuropsychiatric symptom in mild to moderate stages of Alzheimer¡¯s disease (AD) and increases in severity as the dementia progresses. Apathy is complex to treat in AD since it is often mixed with other challenging behaviors and confused with depression [2]. A review of scientific evidence shows that pharmacological therapies are not particularly effective for management of these mixed symptoms and further complicated by dangerous side effects [3]. With an estimated 5.5 million Americans with dementia, safe, effective, and easy to deliver therapies are desperately needed for this problem [1, 3¨C5]. Apathy is defined as the loss of motivation not attributable to cognitive impairment, emotional distress, or reduced level of consciousness [5]. Apathy occurs in approximately 70% of Alzheimer¡¯s disease (AD) patients within five years of diagnosis [6]. AD patients with apathy require more management and support, given their reliance on others to schedule their activities and initiate tasks even when they
%U http://www.hindawi.com/journals/jar/2011/480890/