Diagnostic criteria for apathy in neurocognitive disorders

David S. Miller, Philippe Robert, Larry Ereshefsky, Lawrence Adler, Daniel Bateman, Jeff Cummings, Steven T. DeKosky, Corinne E. Fischer, Masud Husain, Zahinoor Ismail, Judith Jaeger, Alan J. Lerner, Abby Li, Constantine G. Lyketsos, Valeria Manera, Jacobo Mintzer, Hans J. Moebius, Moyra Mortby, Didier Meulien, Stephane PollentierAnton Porsteinsson, Jill Rasmussen, Paul B. Rosenberg, Myuri T. Ruthirakuhan, Mary Sano, Carla Zucchero Sarracini, Krista L. Lanctôt

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Introduction: Apathy is common in neurocognitive disorders (NCD) but NCD-specific diagnostic criteria are needed. Methods: The International Society for CNS Clinical Trials Methodology Apathy Work Group convened an expert group and sought input from academia, health-care, industry, and regulatory bodies. A modified Delphi methodology was followed, and included an extensive literature review, two surveys, and two meetings at international conferences, culminating in a consensus meeting in 2019. Results: The final criteria reached consensus with more than 80% agreement on all parts and included: limited to people with NCD; symptoms persistent or frequently recurrent over at least 4 weeks, a change from the patient's usual behavior, and including one of the following: diminished initiative, diminished interest, or diminished emotional expression/responsiveness; causing significant functional impairment and not exclusively explained by other etiologies. Discussion: These criteria provide a framework for defining apathy as a unique clinical construct in NCD for diagnosis and further research.

Original languageEnglish
Pages (from-to)1892-1904
Number of pages13
JournalAlzheimer's and Dementia
Issue number12
StatePublished - Dec 2021


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