Browsing by Subject "Apathy"

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    An investigation of functional correlates and predictors of apathy in a Memory Clinic sample
    (2025) Sebolai, Katlego; Njomboro, Progress
    Apathy is a common neuropsychiatric symptom in neurological and psychiatric illnesses and is associated with adverse outcomes, significant caregiver burden, cognitive and functional impairment, and poor quality of life. Marin's (1991) definition of apathy as an amotivational disorder has gained widespread acceptance, despite recent contentions about this conceptualization. Marin's Apathy Evaluation Scale reflects his view on apathy as constituted by motivation related deficits. In this study I used Marin's Apathy Evaluation scale to assess apathy in a sample of patients (n = 200) presenting at the University of Cape Town/Groote Schuur Hospital's memory clinic with a query of subjective cognitive impairment. I then investigated the cognitive and functional correlates of apathy in this sample. Due to recent debates on the dimensions of apathy symptoms and the disorder's diagnostic features, I initially performed an exploratory factor analysis of the Apathy Evaluation Scale to determine its factors. I then examined associations between the resulting factors or dimensions of the AES and disease-related characteristics such as depressive symptoms (measured on the Cornell Scale for Depression), year-on cognitive impairment (measured on the Deterioration Cognitive Observee), and functional impairment (measured on the Bristol Activities Daily Living Scale). I found that depression and functional impairment were significant predictors of apathy. Behavioral, cognitive, and emotional subdomains of apathy predicted decline in basic and instrumental activities of daily living differently. Lastly, year-on cognitive impairment was not a predictor of apathy. Results from the exploratory factor analysis supported a three-factor model of the Apathy Evaluation Scale but it yielded a sub-domain of social apathy instead of emotional apathy. Previous factor analysis studies reported emotional apathy, together with behavioral and cognitive apathy as sub-domains of apathy. Results from this study have important implications for understanding factors that influence patients' capacities for performing activities of daily living and meeting their functional needs.
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    Exploring social cognition in patients with apathy following acquired brain damage
    (2014-01-23) Njomboro, Progress; Humphreys, Glyn W; Deb, Shoumitro
    Abstract Background Research on cognition in apathy has largely focused on executive functions. To the best of our knowledge, no studies have investigated the relationship between apathy symptoms and processes involved in social cognition. Apathy symptoms include attenuated emotional behaviour, low social engagement and social withdrawal, all of which may be linked to underlying socio-cognitive deficits. Methods We compared patients with brain damage who also had apathy symptoms against similar patients with brain damage but without apathy symptoms. Both patient groups were also compared against normal controls on key socio-cognitive measures involving moral reasoning, social awareness related to making judgements between normative and non-normative behaviour, Theory of Mind processing, and the perception of facial expressions of emotion. We also controlled for the likely effects of executive deficits and depressive symptoms on these comparisons. Results Our results indicated that patients with apathy were distinctively impaired in making moral reasoning decisions and in judging the social appropriateness of behaviour. Deficits in Theory of Mind and perception of facial expressions of emotion did not distinguish patients with apathy from those without apathy. Conclusion Our findings point to a possible socio-cognitive profile for apathy symptoms and provide initial insights into how socio-cognitive deficits in patients with apathy may affect social functioning.
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    The effects of apathy and depression on cognitive and functional outcomes in Alzheimer's disease
    (2021) Lekhutlile, Tlholego; Njomboro, Progress
    Alzheimer's disease (AD) is the most common cause of dementia initially characterised by short-term memory deficits followed by a progressive cross domain cognitive and functional decline over time and loss of independence in carrying out activities of daily living (ADL). Apathy and depression are also the two most frequent neuropsychiatric sequalae associated with AD and have an impact on patients' ability to execute ADLs. Little is still known if apathy subdomains differently predict ADL performance in these patients. In this study, we aimed to quantitatively investigate if global apathy and depression predict ADL performance. We also wanted to establish if the apathy evaluation scale (AES) items resolve into three factors as proposed by Marin and if those factors differently predict performance of ADLs. We recruited a sample of 115 patients diagnosed with probable or possible AD. Basing on current literature, we hypothesised that apathy and depression predict ADL performance. We also hypothesised that AES items will load into three factors relating to cognitive, behavioural and affective apathy subdomains and that these subdomains will differentially predict ADL performance in our patient sample. Our results indicated that high apathy and depression symptoms were associated with problems to carryout ADLs. They also indicated that AES items resolved into a three factor solution in analogy with Marin's conceptualisation but they did not cluster in the manner that he proposed. Finally, when these factors are regressed simultaneously, (derived from factor analysis) only behavioural apathy significantly predicted ADLs.