Quality of Life in Community-Dwelling Older Persons with Apathy Isis Groeneweg-Koolhoven, M.D., Margot W.M. de Waal, Ph.D., Gerda M. van der Weele, M.D., Ph.D., Jacobijn Gussekloo, M.D., Ph.D., Roos C. van der Mast, M.D., Ph.D. Objective: To investigate the relationship between apathy and perceived quality of life in groups both with and without depressive symptoms or cognitive impairment. Methods: We conducted a cross-sectional study comparing quality of life in older persons with and without apathy in 19 Dutch general practices. Participants were 1,118 older persons aged at least 75 years without current treatment for depression and a Mini-Mental State Examination score of at least 19. Perceived quality of life was determined using Cantril’s Ladder for overall quality of life, EuroQol (EQ)-5D thermometer for subjective health quality, and De Jong-Gierveld Loneliness ques- tionnaire for perceived loneliness. Apathy was assessed with the Apathy Scale. Results: Of the 1,118 older persons, apathy was present in 122 (11%) of them. Overall, apathy was associated with having no work, lower level of education, presence of depressive symptoms, cognitive impairment, and decreased scores on all quality of life measures. Among the 979 (88%) older persons without depressive symptoms and cognitive impairment, apathy was present in 73 (7.5%) of them, showing similar associations as in the total population. In the 77 (7%) persons with cognitive impairment only, apathy was correlated to a lower score on the EQ-5D thermometer. However, in the 51 (5%) depressed persons without cognitive impair- ment, presence of apathy did not contribute to their decreased quality of life. Conclusion: Apathy frequently occurred in community-dwelling older persons, also in the absence of depressive symptoms and cognitive impairment. In them, apathy contributed to the perception of a diminished quality of life in various aspects of daily life. (Am J Geriatr Psychiatry 2014; 22:186e194) Key Words: Apathy, quality of life, cognition, elderly, general population A pathy is an important behavioral syndrome of several neuropsychiatric diseases, including depression and dementia, and is associated with reduced daily functioning, 1e5 caregiver distress, 6,7 and poor functional outcome. 3,4,8e14 Consensus diagnostic criteria for apathy have been proposed 15 and tested in clinical populations suffering from different neuropsychiatric diseases. 16 Apathy is Received January 19, 2012; revised August 30, 2012; accepted October 26, 2012. From the Elderly Psychiatry Hospital Parnassia Bavo Group (IG-K), Rotterdam, The Netherlands; and Department of Psychiatry (IG-K), Department of Public Health and Primary Care (MWMW, GMW, JG), and Old Age Psychiatry Department of Psychiatry (RCM), Leiden University Medical Center, Leiden, The Netherlands. Send corre- spondence and reprint requests to Isis Groeneweg-Koolhoven, M.D., Department of Psychiatry, B1-P, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. e-mail: isisgroen56@gmail.com Ó 2014 American Association for Geriatric Psychiatry http://dx.doi.org/10.1016/j.jagp.2012.10.024 186 Am J Geriatr Psychiatry 22:2, February 2014