Objective: This study aims to investigate the impact of apathy and impulsivity on the quality of life and burden for carergivers of people with Atypical Parkinsonian Syndromes.

Background: Atypical Parkinsonian Syndromes are progressive neurodegenerative disorders with diverse impairments of motor and non-motor functions. Apathy and impulsivity are common features. As these conditions progress, patients typically become highly dependent on caregivers. It is proposed that a patient’s behavioural changes have a bigger impact on caregiver burden than direct consequences of motor impairment, such as difficulty in performing activities of daily living. Apathy and impulsivity, specifically, have been shown to increase caregiver burden in related neurological conditions.

Method: 29 participants diagnosed with Atypical Parkinsonian Syndromes were recruited from patients attending a regional specialist clinic. The Revised Cambridge Behavioural Inventory was used to estimate their degree of apathy, impulsivity and ability to perform everyday activities. Caregivers responded to self-rating measures of quality of life and caring burden. Spearman’s rank correlation coefficient and Bonferroni test were employed for data analysis.

Results: A strong, positive, statistically significant correlation (p<0.01) was found between patients’ apathy, caregiving burden and poorer caregiver quality of life, irrespective of disease duration. Impulsivity appeared to have no statistically significant correlation with caregiver quality of life or burden. Apathy and impulsivity did not correlate with disease duration, while difficulty with activities of daily living appeared to grow with progression (p<0.01). Study limitations include a small sample size and the assumption that participants’ perceptions accurately depict reality.

Conclusion: Apathy and impulsivity may occur at any stage of Atypical Parkinsonian Syndromes and do not simply follow disease progression. Early assessment, identification and continued management of patients’ non-motor symptoms, with pharmacological and non-pharmacological approaches, might reduce caregivers’ burden and improve quality of life.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-apathy-and-impulsivity-on-caregivers-in-atypical-parkinsonian-syndromes/