Apathy in relation to falls and physical functioning in older persons: Why care?

Apathy is being recognized as one of the most frequent behavioral changes in ageing populations, especially in the context of neuropsychiatric disorders such as dementia and depression. The main aim of this thesis was to investigate the associations between apathy, falls and physical functioning in an older population. The second aim was to explore discrepancies between self-reported and performance based measures of physical functioning, and to investigate to what extent symptoms of apathy and depression predict underestimation of one’s physical capability. We concluded that in older persons, apathy associates with falls and functional decline, and that the strength of these associations varies with biological age. Next, we demonstrated that older persons tend to overestimate their level of physical functioning. We also found that negative emotions may underlie underestimation of physical functioning, but not apathetic symptoms (i.e. indifference).
The findings underline the need for clinicians to become aware that recognizing apathetic symptomatology in older persons is relevant. To facilitate this, comprehensive and well validated tools for apathy assessment are warranted. We recommend further research to determine the effectiveness of both fall prevention strategies and guidelines that promote an active lifestyle in older persons with apathy, as it is unknown whether in this population alternative strategies are needed. This is important, as the tendency is to accept apathy-related non-compliance and not adjust to the needs of this particular patient group. Further knowledge on these topics may help care workers and clinicians to provide more effective care and reduce the risk of nonsensical care and therewith unnecessary health costs.