Background: Apathy is highly prevalent in dementia and is also seen in mild cognitive impairment and the general population. Apathy contributes to failure to undertake daily activities and can lead to health problems or crises. It is therefore important to assess apathy. However, there is currently no gold standard measure of apathy. A comprehensive systematic review of the measurement properties of apathy scales is required. Methods: A systematic review was registered with PROSPERO (ID: CRD42018094390). MEDLINE, Embase, PsycINFO, and CINAHL were searched for studies that aimed to develop or assess the validity or reliability of an apathy scale in participants over 65 years, living in the community. A systematic review was conducted in line with the COnsensus-based Standards for the selection of health Measurement INstruments procedure for reviewing patient-reported outcome measures. The studies’ risk of bias was assessed, and all relevant measurement properties were assessed for quality. Results were pooled and rated using a modified Grading of Recommendations Assessment, Development, and Evaluation procedure. Results: Fifty-seven publications regarding 18 measures and 39 variations met the eligibility criteria. The methodological quality of individual studies ranged from inadequate to very good and measurement properties ranged from insufficient to sufficient. Similarly, the overall evidence for measurement properties ranged from very low to high quality. The Apathy Evaluation Scale (AES) and Lille Apathy Rating Scale (LARS) had sufficient content validity, reliability, construct validity, and where applicable, structural validity and internal consistency. Conclusion: Numerous scales are available to assess apathy, with varying psychometric properties. The AES and LARS are recommended for measuring apathy in older adults and people living with dementia. The apathy dimension of the commonly used Neuropsychiatric Inventory should be limited to screening for apathy.
Dement Geriatr Cogn Disord

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老年人和痴呆症患者的冷漠测量：使用 COSMIN 方法对测量特性进行系统审查

背景：冷漠在痴呆症中非常普遍，也见于轻度认知障碍和普通人群。冷漠会导致无法进行日常活动，并可能导致健康问题或危机。因此，评估冷漠很重要。然而，目前没有衡量冷漠的黄金标准。需要对冷漠量表的测量特性进行全面的系统审查。方法：系统评价已在 PROSPERO 注册（ID：CRD42018094390）。在 MEDLINE、Embase、PsycINFO 和 CINAHL 中搜索旨在开发或评估生活在社区的 65 岁以上参与者的冷漠量表的有效性或可靠性的研究。根据基于共识的选择健康测量仪器程序的标准进行了系统审查，以审查患者报告的结果措施。评估了研究的偏倚风险，并评估了所有相关测量属性的质量。使用修改后的建议评估、开发和评估程序分级对结果进行汇总和评级。结果：涉及 18 项措施和 39 项变化的 57 份出版物符合资格标准。个别研究的方法学质量从不充分到非常好，测量特性从不足到充分。同样，测量属性的总体证据从非常低到高质量不等。冷漠评估量表 (AES) 和里尔冷漠评定量表 (LARS) 具有足够的内容效度、可靠性、结构效度，以及适用的结构效度和内部一致性。结论：许多量表可用于评估冷漠，具有不同的心理测量特性。建议使用 AES 和 LARS 来测量老年人和痴呆症患者的冷漠程度。常用神经精神病学量表的冷漠维度应仅限于筛查冷漠。
老年痴呆症认知障碍