Apathy and social behavior in two samples of older adults

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Abstract INTRODUCTION Changes in social behavior are common in older people with cognitive impairment and may be partly due to apathy. We investigated the association between apathy and social behavior in older adults. METHODS Cross‐sectional study using data on (1) 116 community‐dwelling older adults with mild Alzheimer's dementia; (2) 52 older care home residents with and without dementia. Apathy and social behavior were proxy‐reported using, respectively, the Neuropsychiatric Inventory and the Revised Self‐Monitoring Scale (RSMS). RESULTS In age/sex‐adjusted analyses, community‐dwelling participants with moderate apathy scored 12.4 (4.5, 20.3) RSMS points lower than those without apathy, and care home residents with moderate apathy scored 13.5 (3.6, 23.4) points lower. Associations were maintained in the community‐dwelling sample when additionally adjusted for cognitive impairment and depression. DISCUSSION Apathy is associated with impaired social behavior although causality is unclear, necessitating future longitudinal studies. Recognizing and addressing apathy may improve social connection and quality of life. Highlights Older adults with apathy had impaired social behavior compared to those without. This was consistent in cognitively‐impaired community and care home samples. These findings were independent of depressive symptoms and cognitive impairment. Future work should clarify the causal direction in people with dementia. Apathy should be assessed and managed to improve social behavior in people with dementia.

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