Symptoms of apathy and passivity in dementia: A simultaneous concept analysis.
Andrea Gilmore-Bykovskyi, Laura Block, Rachel Johnson and 1 others
PMID 30184283WHAT IT FOUND
Apathy and passivity in dementia overlap but are not interchangeable.
Apathy centres on low motivation, interest and initiative; passivity centres on slowed movement and reduced interaction with people or environment.
Key findings
01Apathy was most commonly defined by decreased motivation, decreased interest or concern, and lack of self-initiated goal-directed behaviour.
02Passivity was most commonly described by decreased psychomotor activity, emotional blunting, and reduced interaction with people or the environment.
03Apathy was distinguished by lack of goal-directed behaviour, insight and self-care initiation, while passivity was distinguished by emotional blunting, psychomotor changes and lack of interaction with the environment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used English articles published from 1980 to 2015, so relevant non-English or newer work may be missing. Apathy had 156 included articles, but passivity had only 20, so the comparison is uneven. The team noted potential interpretation bias in coding definitions, even though two reviewers coded independently. The included primary studies mostly lacked longitudinal designs, so the paper cannot establish the timing of antecedents and consequences. This is a concept analysis of definitions, not a clinical trial, so it does not show whether any intervention works.
Declared interests
The authors declare no potential conflicts of interest.
The easy way to misread this
Do not read this as evidence that any treatment reduces apathy or passivity. The paper analysed how published articles defined the symptoms; it did not test an intervention in patients.