Diagnostic criteria for apathy in neurocognitive disorders.
Miller DS., Robert P., Ereshefsky L., Adler L., Bateman D., Cummings J., DeKosky ST., Fischer CE., Husain M., Ismail Z., Jaeger J., Lerner AJ., Li A., Lyketsos CG., Manera V., Mintzer J., Moebius HJ., Mortby M., Meulien D., Pollentier S., Porsteinsson A., Rasmussen J., Rosenberg PB., Ruthirakuhan MT., Sano M., Zucchero Sarracini C., Lanctôt KL.
INTRODUCTION: Apathy is common in neurocognitive disorders (NCD) but NCD-specific diagnostic criteria are needed. METHODS: The International Society for CNS Clinical Trials Methodology Apathy Work Group convened an expert group and sought input from academia, health-care, industry, and regulatory bodies. A modified Delphi methodology was followed, and included an extensive literature review, two surveys, and two meetings at international conferences, culminating in a consensus meeting in 2019. RESULTS: The final criteria reached consensus with more than 80% agreement on all parts and included: limited to people with NCD; symptoms persistent or frequently recurrent over at least 4 weeks, a change from the patient's usual behavior, and including one of the following: diminished initiative, diminished interest, or diminished emotional expression/responsiveness; causing significant functional impairment and not exclusively explained by other etiologies. DISCUSSION: These criteria provide a framework for defining apathy as a unique clinical construct in NCD for diagnosis and further research.