Apathy in Dementia Care: An Investigation in Community-Dwelling Persons Using the German Informant Version of the Apathy Evaluation Scale

Apathy is a diminished goal-directed behavior stemming from a lack of motivation. It is one of the most common symptoms in dementia. While the Apathy Evaluation Scale (AES) has proved to be a psychometrically robust measure for assessing apathy, the German version (AESD) requires further validation. Associations of apathy with important variables in dementia care, such as cognitive impairment or caregiver burden, were repeatedly found, though contradictory findings have also been reported. The present study assessed apathy in 100 community-dwelling persons with dementia. Their informal and formal caregivers used the German informant version of the Apathy Evaluation Scale (AESD-I) to investigate the severity of dementia and cognitive deficits as measured with the Mini-Mental State Examination (MMSE) and Global Deterioration Scale (GDS), respectively. A reliability analysis was performed to estimate the internal consistency of the AESD-I, and the data were tested for potential correlations with results from a shortened version of the AESD-I (AESD16-I). Cronbach's α was .880 for the AESD-I and .904 for the AESD16-I. The prevalence of apathy was 77%, its severity was on average moderate to high. Significant (p < .05) negative correlations were shown between the AESD16-I, the Barthel Index (BI), and the Quality of Life-Alzheimer's Disease (QOL-AD). Correlations between the AESD16-I, GDS, and Zarit Burden Interview were positive. After Bonferroni correction, the only correlations that remained significant were between the AESD16-I and BI and QOL-AD. The present study underlines the favorable psychometric properties of the AESD-I and confirms the high prevalence of apathy with considerable severity in the sample of community-dwelling persons with dementia. In addition, it contributes to the diversity of evidence on clinical correlates of apathy which require further clarification.