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

Burgon, Clare; Goldberg, Sarah; van der Wardt, Veronika; Harwood, Rowan H.

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.

Citation

Burgon, C., Goldberg, S., van der Wardt, V., & Harwood, R. H. (2023). Experiences and understanding of apathy in people with neurocognitive disorders and their carers: a qualitative interview study. Age and Ageing, 52(3), Article afad031. https://doi.org/10.1093/ageing/afad031

• Journal Article Type: Article
• Acceptance Date: Jan 19, 2023
• Online Publication Date: Mar 15, 2023
• Publication Date: Mar 1, 2023
• Deposit Date: Jan 25, 2023
• Publicly Available Date: Mar 2, 2024
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Peer Reviewed: Peer Reviewed
• Volume: 52
• Issue: 3
• Article Number: afad031
• DOI: https://doi.org/10.1093/ageing/afad031
• Keywords: Apathy, qualitative research, dementia, mild cognitive impairment, neuropsychiatric symptoms, older people, Ageing, Community Geriatrics, Dementia and Related Disorders
• Public URL: https://nottingham-repository.worktribe.com/output/16500063
• Publisher URL: https://academic.oup.com/ageing/article/52/3/afad031/7078335