Apathy in Korsakoff Syndrome: A Call for Clinical Awareness in Long-Term Care Settings

Objectives: Apathy is a prominent neuropsychiatric symptom in Korsakoff syndrome (KS), yet its multidimensional aspects and correlates remain underexplored. This study evaluates the prevalence, subtypes, and associated factors of apathy in patients with KS residing in long-term care facilities. Design: A cross-sectional study analyzing apathy prevalence, subtypes, and associated factors. Setting and Participants: Twelve specialized long-term care facilities in the Netherlands; a total of 175 patients with KS residing in long-term care facilities. Methods: Apathy was assessed using the Apathy Evaluation Scale–Informant version (AES-I) and the Apathy Motivation Index–Caregiver version (AMI-CG), categorizing subtypes into behavioral activation, social motivation, and emotional sensitivity. Demographic variables and psychotropic medication use were analyzed. Results: Apathy was highly prevalent, with 76% of patients classified as apathetic on the AES-I and 82.3% on the AMI-CG. All apathy subtypes demonstrated high total scores, particularly social motivation. Antipsychotic use was significantly associated with increased apathy levels. During COVID-19 lockdown, apathetic patients exhibited a significant decline in activity levels, with only partial recovery post-lockdown. Conclusions and Implications: Apathy is a pervasive symptom in KS, significantly associated with antipsychotic medication use and contributing to reduced activity levels. These findings emphasize the need for routine apathy assessment, cautious antipsychotic use, and tailored nonpharmacologic interventions to address apathy in this vulnerable population.