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The efficacy of nonpharmacological treatment for dementia-related apathy


Ferrero-Arias, Julio, Goñi-Imízcoz, Miguel, González-Bernal, Jerónimo, Lara-Ortega, Fernando, da Silva-González, Alvaro, Díez-Lopez, Mateo


Alzheimer Disease And Associated Disorders, Volume: 25, No.: 3, Pages.: 213-219

Year of Publication



Objective: To determine the usefulness of a formal, structured, nonpharmacological treatment for apathetic dementia patients.; Patients and Methods: A controlled, cross-over, randomized, simple-blind, multicentre clinical trial. A total of 146 institutionalized or day care dementia patients with a stage 1 or 2 Clinical Dementia Rating, with no significant motor or sensory problems, or with rapidly evolving dementia and in a clinically stable state were recruited. A cognitive mini examination, and functional, depression, and potential toxicity scales, Neuropsychiatric Inventory Questionnaire (NPI-Q), and Dementia Apathy Interview and Rating (DAIR) scales were applied at baseline. Patients were randomized to initial intervention (music and art therapy and psychomotor activity) or initial control (free activities in the day room) and changed over at 4 weeks. NPI-Q and DAIR scales were administered at the end of weeks 4 and 8.; Results: A significant difference between intervention and control periods, as measured using the DAIR scale, was observed, with a difference of 0.21 (95% confidence interval: 0.07-0.34, P<0.005). The difference was very important in the patients with moderated apathy. However, differences were not so important in the patients with severe apathy and there were no differences at all in the non-apathetic patients. No significant differences were found with the NPI-Q scale, although there was a clear improvement trend in the "apathy" question on this scale. This effect seems to extend beyond the therapeutic intervention period.; Conclusions: A structured, nonpharmacological, short-term occupational therapy intervention is more useful than activities of the patients' own choice for improving apathy in patients with mild or moderate dementia.;

Bibtex Citation

@article{Ferrero_Arias_2011, doi = {10.1097/wad.0b013e3182087dbc}, url = {}, year = 2011, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {25}, number = {3}, pages = {213--219}, author = {Julio Ferrero-Arias and Miguel Go{~{n}}i-Im{'{i}}zcoz and Jer{'{o}}nimo Gonz{'{a}}lez-Bernal and Fernando Lara-Ortega and {'{A}}lvaro da Silva-Gonz{'{a}}lez and Mateo D{'{i}}ez-Lopez}, title = {The Efficacy of Nonpharmacological Treatment for Dementia-related Apathy}, journal = {Alzheimer Disease {&} Associated Disorders} }


aged, aged, 80 and over, apathy, complications, dementia, female, humans, male, middle aged, neuropsychological tests, occupational therapy, psychology, rehabilitation

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Behaviour, Other


Long Term Residential Care without medically trained staff, Nursing Homes

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Arts and Music Interventions (including Art and Music Therapy), Occupational Therapy