Experiences and understanding of apathy in people with neurocognitive disorders and their carers: a qualitative interview study

Abstract Background apathy, defined as reduced goal-directed activity, interests and emotion, is highly prevalent in neurocognitive disorders (NCDs). Apathy has important consequences for the individuals who experience it and their carers, yet the lived experiences of apathy in this population are n...

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Bibliographic Details
Published in:Age and ageing 2023-03, Vol.52 (3)
Main Authors: Burgon, Clare, Goldberg, Sarah, van der Wardt, Veronika, Harwood, Rowan H
Format: Article
Language:English
Subjects:
Apathy
Autonomy
Caregivers
Caregivers - psychology
Cognition
Cognitive ability
Cognitive impairment
Dementia
Dementia - psychology
Dementia disorders
Emotional behavior
Humans
Identity
Interviews
Neurocognition
Neurocognitive Disorders
Qualitative Paper
Qualitative Research
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Summary:Abstract Background apathy, defined as reduced goal-directed activity, interests and emotion, is highly prevalent in neurocognitive disorders (NCDs). Apathy has important consequences for the individuals who experience it and their carers, yet the lived experiences of apathy in this population are not well understood. Objective to explore how people with NCDs and their carers understand and experience apathy. Method in-depth semi-structured interviews were conducted in participants’ homes. Sixteen people with NCDs (dementia or mild cognitive impairment) and 14 carers, living in four geographical areas of England, took part. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using reflexive thematic analysis. Results four themes were generated: ‘Apathy is Poorly Understood’; ‘Too much trouble: Mediating Effort and Outcome’; ‘Preserving Identity in the Face of Loss of Capability and Autonomy’ and ‘Opportunity and Exclusion’. Conclusion apathy is experienced as an understandable response to the everyday struggle people with NCDs face to preserve identity in the face of threats to capability and autonomy and is exacerbated by the lack of support and opportunities. Social and environmental modifications may help reduce apathy. In line with previous qualitative research, this challenges the dominant view of apathy as a neuropsychiatric symptom that excludes the social–environmental context.
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/afad031