Dementia has overtaken coronary heart disease as the leading cause of premature death in older Australians.
Mild cognitive impairment, or MCI is a condition which affects cognitive abilities like memory and language. Those with MCI may have more difficulty remembering recent events, names or appointments, and may have trouble following complex directions or making decisions. But they can still perform most of their daily activities on their own. This condition is a transition stage between the normal cognitive decline of ageing and the more severe decline of dementia.
While not everyone with MCI will develop dementia, research suggests people with MCI are at a higher risk of progression than those without it. One common symptom of MCI is apathy – defined as limited motivation and goal-seeking.
The broader question is whether this apathy acts as a predictor of dementia down the track or its severity?
In a new study, data was collected on almost 200 people with mild cognitive impairment including each person’s level of apathy and depression. Levels of apathy gradually increased in the cohort the longer people were followed – at baseline, about a third of people had indications of apathy but three years into the study that grew to almost half of participants. Depression, on the other hand, was relatively constant throughout the study period.
They found that apathy was a marker of more severe clinical outcomes – that is, people with MCI and apathy were more likely to have worse cognition, poorer function, caregiver burden and dementia severity (when it developed) compared to those with MCI but without apathy. They contrasted that finding with depression, which was linked with a much narrower set of outcomes and didn’t increase over time.
The authors say these findings suggest clinicians should be on the lookout for those with apathetic mood, as this may indicate a higher likelihood of severe symptoms linked with MCI or a greater likelihood of developing dementia.