Evidence map›Paper›PMID 33949763›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2021

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 and 17 more

Open access · hybridAbstract read
In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 5 pooled it
12.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 5 syntheses or guidelines pooled it, 165 citations in OpenAlex.

  1. The prevalence of apathy in Lewy body dementia: A systematic review and meta-analysis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
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  17. On the relationships between apathy, depression and anhedonia.Journal of neurology, neurosurgery, and psychiatry · 2026
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42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 20 institutions in 8 countries.

David S MillerSignant Health, Blue Bell, Pennsylvania, USA.
Philippe RobertCognition Behaviour Technology Lab, Université Côte d'Azur, Nice, France.
Larry EreshefskyFollow the Molecule, Marina del Rey, California, USA.
Lawrence AdlerDepartment of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Daniel BatemanDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Jeff CummingsDepartment of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, Nevada, USA.
Steven T DeKoskyDepartment of Neurology, McKnight Brain Institute, University of Florida, Gainesville, Florida, USA.
Corinne E FischerInstitute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Masud HusainDepartment of Experimental Psychology, University of Oxford, Oxford, UK.
Zahinoor IsmailHotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Judith JaegerCognitionMetrics, Wilmington, Delaware, USA.
Alan J LernerUniversity Hospitals - Case Western Reserve University, Cleveland, Ohio, USA.
Abby LiSunnybrook Research Institute, Toronto, Ontario, Canada.
Constantine G LyketsosJohns Hopkins University, Baltimore, Maryland, USA.
Valeria ManeraCognition Behaviour Technology Lab, Université Côte d'Azur, Nice, France.
Jacobo MintzerMedical University of South Carolina and Ralph H. Johnson Veterans Administration Medical Center, Charleston, South Carolina, USA.
Hans J MoebiusMoebius-Consult, Baar, Switzerland.
Moyra MortbyUNSW Ageing Futures Institute, The University of New South Wales, Sydney, Australia.
Didier MeulienClinical Research and Development, H. Lundbeck A/S, Valby, Denmark.
Stephane PollentierBoehringer Ingelheim Pharma GmbH & Co KG, CNS Diseases Research, Biberach an der Riss, Germany.
Anton PorsteinssonUniversity of Rochester, Rochester, New York, USA.
Jill RasmussenPsi-Napse, Dorking, UK.
Paul B RosenbergJohns Hopkins University, Baltimore, Maryland, USA.
Myuri T RuthirakuhanSunnybrook Research Institute, Toronto, Ontario, Canada.
Mary SanoAlzheimer Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Carla Zucchero SarraciniSunnybrook Research Institute, Toronto, Ontario, Canada.
Krista L LanctôtSunnybrook Research Institute, Toronto, Ontario, Canada.ORCID 0000-0001-7024-6637
Sunnybrook Hospital · CAJohns Hopkins University · USAmt für Gemeinden und Raumordnung · CHAssociation France Alzheimer · FRBoehringer Ingelheim (Germany) · DECentre Hospitalier Universitaire de Nice · FRCleveland Clinic · USDorking Community Hospital · GBIcahn School of Medicine at Mount Sinai · USIndiana University School of MedicineLundbeck (Denmark) · DKMarina Del Rey Hospital · USMedical University of South Carolina · USSt. Michael's Hospital · CAUniversity Hospitals of Cleveland · USUniversity of Calgary · CAUniversity of Florida · USUniversity of Maryland, Baltimore · USUniversity of Oxford · GBUniversity of Rochester · US

Funding

Trial-Ready Cohort for Preclinical/Prodromal Alzheimer's DiseaseR01AG053798 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI AISEN, PAUL S., CUMMINGS, JEFFREY L. · 2017 to 2022
$39.4M
Research Education ComponentP30AG066507 · NIA · JOHNS HOPKINS UNIVERSITY · PI Corinne Pettigrew · 2020 to 2026
$29.3M
Research Education ComponentP30AG072980 · NIA · BANNER HEALTH · PI HEATHER Allyson BIMONTE-NELSON · 2021 to 2026
$24.9M
Renewal of Centers of Biomedical Research Excellence (COBRE) (Phase 2) CNTN - ResubmissionP20GM109025 · NIGMS · CLEVELAND CLINIC FOUNDATION · PI Robert J. Fox, Jefferson Kinney · 2015 to 2026
$22.8M
Chronic Traumatic Encephalopathy: Detection, Diagnosis, Course, and Risk FactorsU01NS093334 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI CUMMINGS, JEFFREY L., REIMAN, ERIC MICHAEL · 2016 to 2022
$17.0M
NVEDARC Clinical CoreP20AG068053 · NIA · CLEVELAND CLINIC FOUNDATION · PI RITTER, AARON · 2020 to 2022
$3.3M
Mobile Assessment of Behavioral and Psychological Symptoms of Dementia in Adults with Alzheimer's DiseaseK23AG059914 · NIA · INDIANA UNIVERSITY INDIANAPOLIS · PI BATEMAN, DANIEL · 2019 to 2020
$358k
NIA NIH HHS K23 AG059914NIA NIH HHS P20 AG068053NIA NIH HHS P30 AG066507NIA NIH HHS P30 AG072980NIA NIH HHS R01 AG053798NIGMS NIH HHS P20 GM109025NINDS NIH HHS U01 NS093334
6 · The paper itself

Abstract

introductionApathy is common in neurocognitive disorders (NCD) but NCD-specific diagnostic criteria are needed.

methodsThe 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.

resultsThe 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.

Indexed as

ConsensusDelphi TechniqueExpert TestimonyApathyEmotionsHumansMotivationNeurocognitive Disordersapathybehaviorcognitiondiagnostic criteriaemotionmotivationneurocognitive disorder (NCD)neuropsychiatric symptoms (NPS)

Identifiers

PMID33949763
PMCPMC8835377
OpenAlexW3159103876

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.