Apathy and Anhedonia Rating Scales in Parkinson's Disease: Critique and Recommendations

Apathy is a common condition in Parkinson's disease (PD) and is generally defined as a lack of motivation. It is associated with more severe cognitive dysfunction and a decrease ill activities of daily living (ADL) performance. Anhedonia. the inability to experience pleasure. call be a symptom of both depressive and apathetic syndromes. The Movement Disorder Society PODS) commissioned a task force to assess the clinimetric properties of apathy and anhedonia scales in PD patients. A systematic literature review was conducted to identify scales thin have either been validated or used in PD Patients. Apathy scales identified for review include the Apathy Evaluation Scale (AES). the Apathy Scale (AS). the Apathy Inventory (M). and the Lille Apathy Rating Scale (LARS). In addition. item 4 (motivation/initiative) Unified Parkinson's of the Disease Rating, Scale (UPDRS) and item 7 (apathy) of the Neuropsychiatric Inventory (NPI) were included. Anhedonia scales identified for review were the Snaith-Hamilton Pleasure Scale (SHAPS) and the Chapman scales for physical and social anhedonia. Only the AS is classified as "recommended" to assess apathy in PD. Although item 4 of the UPDRS also meets the criteria to be classified as recommended, it Should he considered for screening only because of the Obvious limitations of a single item construct. For the assessment of anhedonia. only the SHAPS meets the criteria Of "Suggested." Information on the validity of apathy and anhedonia scales is limited because Of the lack of consensus on diagnostic criteria for these conditions. (C) 2008 Movement Disorder Society