A common feature of frontotemporal dementia (FTD) is apathy. Having apathy symptoms, including deficits in working memory and mental/cognitive flexibility, has been linked to worse prognosis and survival for FTD patients. However, its role as an early marker of FTD progression is unclear. The aim of this study was to assess whether apathy in presymptomatic carriers of genetic mutations linked to FTD worsens over time and apathy’s association with cognitive decline and brain atrophy. Using longitudinal latent growth curve modeling, researchers found that apathy in presymptomatic carriers of MAPT, GRN, or C9orf72 mutations (N = 304) occurs early, worsens over time, and predicts cognitive decline across two years. The progression of apathy was also associated with early brain changes (low gray matter volume) in the frontal lobe and cingulate gyrus, areas important for cognition. The findings suggest that apathy is an early marker of cognitive decline and brain changes in presymptomatic FTD as well as an important target for symptomatic treatment and interventions for people at risk.

Malpetti, M., Jones, P. S., Tsvetanov, K. A., Rittman, T., Van Swieten, J. C., Borroni, B., Sanchez-Valle, R., Moreno, F., Laforce, R., Graff, C., Danek, A., Otto, M., Frisoni, G. B., Ghidoni, R., Sorbi, S., Heller, C., Todd, E. G., Bocchetta, M., Cash, D. M., … Rowe, J. B. (2020). Apathy in presymptomatic genetic frontotemporal dementia predicts cognitive decline and is driven by structural brain changes. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 1–15. https://doi.org/10.1002/alz.12252