Bruce Ballard, a board member of PPP, has generously provided the following post. His regular blog can be found at parkingsons.com
Bruce Ballard, Ed.D.
As many of us who are dealing with PD know, apathy is one of the non-motor symptoms we face and feel. Why hit the gym, or go out to lunch with friends, when you can sit on your couch at home, munching Cracker Jack and binge-watching Netflix’s GLOW?
It turns out that apathy is multifaceted and affects us in different ways, according to a recently published report from the United Kingdom (Differential impact of behavioral, social and emotional apathy on Parkinson’s disease, July, 2018). From the opening paragraph:
“Apathy, a disorder of motivation characterized by reduced self-initiated goal-directed behavior, is very common in Parkinson’s disease (PD) and associated with diminished quality of life. Theoretical accounts and new evidence suggest that rather than being a unitary construct, apathy is multidimensional, involving behavioral, cognitive, executive, social, and emotional domains.”
The authors also note that apathy often overlaps with depression and anhedonia (lowered motivation to seek out pleasure and enjoy life).
Their study compared 102 patients with PD to 147 healthy controls. The average age of both groups was about 67 years old, and the Parkies had been living with PD an average of six years. Using a variety of assessment methods, the researchers looked at apathy in three domains:
In general, the Parkies had higher scores on the apathy scale than the healthy controls. However, this was true only for behavioral and social apathy.
“…overall PD patients exhibited higher levels of behavioral and social apathy relative to controls. Emotional apathy, however, did not differ between the two groups.”
Furthermore, Parkies who scored high on behavioral and social apathy were also more likely to be depressed and/or anhedonic. But having emotional apathy did not correlate with also having depression or anhedonia.
The authors suggest that clinicians working with Parkies be careful to tease out depression from apathy and treat each one independently. From their paper:
“Our finding dovetails with other reports which show that apathy can be dissociated from depression in PD. Apathy frequently occurs in the absence of depression, and factor analyses have revealed that the two represent discrete constructs.”
I wonder how many doctors are aware of this….
What’s my response to this news? Well, first off, I saw this article and was keenly motivated to summarize it on my blog. No apathy there!
Second, it makes me think that having Parkinson’s is like turning your body into a theme park with the disease, with all kinds of physical, mental, social, and emotional mishaps and kerfluffles for me to experience day by day. And unlike at other theme parks, I don’t have to wait in line!
And third, I realize that knowledge is power. Now that I know apathy comes in at least three flavors, I’ll be in a better position to identify it within myself…and hopefully give it the boot!