Apathy an Early Marker of Frontotemporal Dementia

Apathy an Early Marker of Frontotemporal Dementia

Apathy is an early marker of frontotemporal dementia (FTD) and predicts future cognitive decline, a new study has shown.

Results showed that apathy occurs early in the disease course of genetic FTD before cognitive decline, reflecting early brain changes and predicting individual future clinical trajectories of cognitive and executive function deterioration.

“Our study shows clearly that apathy is a precursor to FTD. As such, it could help us identify patients before they develop cognitive symptoms and give us the opportunity to help them stay well for longer,” senior author, James B. Rowe, MD, told Medscape Medical News.

The researchers suggest that apathy may also be a modifiable factor in its own right, by pharmacological or nonpharmacological interventions, and it is therefore a potential target not only for symptomatic treatment but also for interventions to delay clinical decline in people at risk for FTD.

“We would encourage family members to encourage individuals who develop apathy to seek medical advice. And we would urge doctors to take apathy seriously and to ask about a family history of dementia. While apathy is a common symptom of depression, not all patients with apathy are depressed,” added Rowe, who is professor of clinical neuroscience at the University of Cambridge, United Kingdom.

The study was published online on December 14 in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association. 

Rowe explained that while apathy occurs in all types of dementia, it is particularly common in FTD and is associated with a worse prognosis including reduced survival and being more likely to need nursing home care.

“As FTD has a strong genetic component, we can sometimes identify individuals relatively early in life who carry the faulty genes and have a high risk of developing the condition later in life. This can give us a head start in trying to take preventive actions,” he said.

In this study, the researchers compared the incidence of apathy in a group of individuals carrying gene variants known to be associated with FTD but before symptoms of the condition had developed and in a group of relatives who did not have such gene variants.

“We know brain changes start 10 to 20 years before cognitive symptoms develop in FTD and we wanted to investigat

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