title: Pharmacological and Nonpharmacological Treatment for Apathy in Alzheimer Disease : A systematic review across modalities
abstract: Apathy is one of the most frequent neuropsychiatric symptoms encountered in Alzheimer disease (AD). Early diagnosis and timely treatment of apathy in AD seem to be of great importance, since apathy has been associated with poor disease outcome, reduced daily functioning, and caregiver distress.
  
  
  
  Within this context, we conducted an extensive electronic search from the databases included in the National Library of Medicine as well as PsychInfo and Google Scholar for studies that have investigated the effect of pharmacological and nonpharmacological treatments of apathy in AD.
  
  
  
  Acetylcholinesterase inhibitors, gingko biloba, methylphenidate, and a variety of nonpharmacological interventions were found to be successful in reducing apathy in patients with AD. Methodological heterogeneity of the studies and the small amount of studies where apathy was a primary outcome measure are limiting factors to evaluate for group effects.
  
  
  
  Treatment of apathy in AD is a complicated and an underexplored field. Standardized and systematic efforts primarily focused on the study of apathy in AD may establish a benefit from individualized treatment for specific disease groups that would stem from a combination of both pharmacological and nonpharmacological interventions.
authors.affiliation: 1 First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.|2 Department of Psychosis Studies, Institute of Psychiatry, King's College, London, United Kingdom.
authors.forename: Christos
authors.initials: C
authors.lastname: Theleritis
authors.affiliation: 1 First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Siarkos
authors.affiliation: 1 First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Everina
authors.initials: E
authors.lastname: Katirtzoglou
authors.affiliation: 1 First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.|3 Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Antonios
authors.initials: A
authors.lastname: Politis
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D057565:Apathy; D017028:Caregivers; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008517:Phytotherapy; D011613:Psychotherapy / Q000379:methods*
chemical_list: D002800:Cholinesterase Inhibitors
keywords: Alzheimer disease; apathy; dementia; nonpharmacological; pharmacological; treatment