Towards a Multidimensional Assessment of Apathy in Neurocognitive Disorders
Résumé
Background
Apathy is a syndrome that affects several dimensions of goal-directed behaviour, cognition, emotions and social interaction. There is a growing interest in understanding apathy and its association to the early stages of neurocognitive disorders such as Alzheimer’s disease, Parkinson’s disease, and frontotemporal dementia. This syndrome is essentially assessed through clinical scales reported by the patient himself or through external observation. To improve apathy assessment, we need multidimensional, objective indicators reliably associated to the classical apathy clinical scales. For this reason, we aimed to combine several tasks and sensors to obtain objective heterogenous apathy measures.
Methods
172 subjects with Mild and Major NCD participated in this study. We employed a combination of behavioural tasks and open questions (“tell me a positive/negative event of your life in one minute”) with the simultaneous recording of the participants’ voices, faces and motor activity (through accelerometers). Apathy scales (Apathy Inventory, Diagnostic Criteria of Apathy) and classical cognitive tests (Mini Mental State, Clinical Dementia Rate Scale) are also administered. Patients were divided into two groups apathetic and non-apathetic using the new Apathy Diagnostic Criteria (Robert et al., 2018).
Results
Audio features (e.g. number of words, prosody) varied significantly between apathetic and non-apathetic subjects. Automated video analysis showed that video features (motion and emotion) present in the videos allowed to correctly classify most participants in respect to apathy. One behavioural task assessing interests showed significant differences between groups. Accelerometer’s data are currently under analysis.
Conclusions
Sensors and ICTs are promising tools for the multidimensional assessment of apathy. The next step would be to use multichannel data analysis to improve apathy assessment. Reference: P. Robert, K. L. Lanctôt, L. Agüera-Ortiz, P. Aalten, F. Bremond,M. Defrancesco, C. Hanon, R. David, B. Dubois, K. Dujardin, M. Husain, A. König, R. Levy, V. Mantua, D. Meulien, D. Miller, H.J. Moebius, J. Rasmussen, G. Robert, M. Ruthirakuhan, F. Stella, J. Yesavage, R. Zeghari, V. Manera (2018). Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group. Reference: European Psychiatry Journal, 54, 71–76.