Reducing the Risk of Apathy in Dementia

Apathy. Jonathan Storey Stone/ Getty Images

What Is Apathy?

Apathy is a lack of interest or motivation that can be observed in a person's affect (mood), behavior and cognition. Apathy is one of several symptoms of depression but it can occur without depression as well. It's important to note that apathy is not the same as depression; people with apathy might not have feelings of sadness. Apathy is often present in Alzheimer's disease and other types of dementia.

Three Types of Apathy in Dementia

  • Affective Apathy: This type of apathy involves a lack of emotions, the appearance of indifference and the absence of empathy. The person may appear not to care about others or lack the warmth with which he used to greet you.
  • Behavioral Apathy: Apathy in behaviors include physical inactivity and tasks left uncompleted. The person might not walk around much or may ignore tasks such as housekeeping or laundry, even though she is physically able to perform them.
  • Cognitive Apathy: Cognitive apathy includes the lack of initiating speech and mental activity, and the absence of interest in others' activities. The person might need prompting in conversation and may appear "zoned out" and uninterested in what's occurring around him.

Read more: How to Cope with Personality Changes in Dementia

Apathy and Dementia

Research has shown that apathy is quite prevalent in dementia.

Specifically, one study found that 56% of the study's participants with an Alzheimer's diagnosis were apathetic, while 72% of the participants with frontotemporal dementia demonstrated apathy.

While apathy is often not as difficult to cope with as other challenging behaviors in dementia (such as hoarding, paranoia or agitation), it can affect the individual's quality of life, safety and ability to live independently.

Responding to Apathy in Dementia

Some research has demonstrated that apathy in dementia can be successfully reduced through programmed interventions. For example, one study found a significant difference in the level of apathy in nursing residents with dementia who were involved in activities once a week for 10 months, as compared to a group of residents who were not involved in those activities.

Offering and engaging the person in meaningful activities is important to ward off apathy. Remember that what is meaningful for one person might not be meaningful for the next. Thus, a person-centered approach is a must to be able to identify and target the interests of each person.

Be flexible and evaluate if the activity is providing periods of success and joy to the person, or if it's too overwhelming and needs to be broken down for her.

People with dementia often struggle with loneliness and boredom, which can contribute to apathy.

Taking a few minutes to sincerely chat with someone could be helpful in reducing apathy.

Sometimes, music is a very effective way to engage someone with dementia who appears apathetic. You will want to research what his or her favorite music has been throughout her life and find a recording of these songs to play for her.

Finally, although non-drug approaches are generally preferred, research has also shown some benefit from acetylcholinesterase inhibitors for improving apathy in dementia.


Alzheimer Society Canada. Apathy. October 11, 2012.

Archives of Neurology. 2009 Jul; 66(7): 888–893. Apathy Symptom Profile and Behavioral Associations in Frontotemporal Dementia vs. Alzheimer's Disease.

Cleveland Clinic. If You Have Apathy You Might Be At Risk for Dementia. June 2, 2014.

Journal of Geriatric Psychiatry 2012; 20(2): 104-122. Pharmacologic treatment of apathy in dementia.

Psychiatry. February 2015, Volume 30, Issue 2, Pages 251–257. Apathy in nursing home residents with dementia: Results from a cluster-randomized controlled trial.

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