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Apathy Evaluation Scale
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NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure of emotional impairment.
Supplemental - Highly Recommended: Mitochondrial Disease (Mito)
Recommendations for Use: Indicated for studies evaluating behavioral and emotional aspects of disease impact
Supplemental: Huntington's Disease (HD)
Short Description of Instrument
Summary/Overview of Instrument: Semi-structured interview with 18 questions assessing apathy in the past four weeks. This scale was originally designed for patients with Parkinson's disease or Alzheimer's disease.
Construct measured: Apathy.
Generic vs. disease specific: Generic.
Intended use of instrument/purpose of tool: Assessment of severity of apathy.
Means of administration: Paper and pencil.
Location of administration: Clinic or home.
Intended respondent: Patient/self (AES-S), Informant (AES-I) and Clinician (AES-C) version.
# of items: 18.
# of subscales and names of sub-scales: None.
Special Requirements for administration: None.
Administration Time: Likely 15-30 minutes.
Translations available: Available in English, German, Dutch, French, Spanish.
Comments/Special Instructions
NeuroRehab Specific: Applicable to the following populations: Alzheimer's disease, multiple sclerosis, Parkinson's disease.
Scoring and Psychometric Properties
Scoring: Rating of each item is based on a semi-structured interview. The interview should begin with a description of the participant's interest, activities and daily routine. The items should be answered based on the participant's thoughts, emotions, and actions; based on both verbal and non-verbal information of the past 4 weeks. For each item ratings should be judged: 4 possible responses for each question: 'not at all', 'slightly', 'somewhat', 'a lot'.
Standardization of scores to a reference population (z scores, T scores): Not available.
If scores have been standardized to a reference population, indicate frame of reference for scoring (general population, HD participants, other disease groups). Not available.
Psychometric Properties:
Reliability: Test-retest or intra-interview (within rater) reliability: AES-S = 0.76; AES-I = 0.94; AES-C = 0.88 Inter-interview (between-rater) reliability (as applicable): Inter-rater reliability was only tested for the AES-C and was found to be good (intraclass correlation coefficient = 0.94 (Marin, 1991). Internal consistency: Coefficient alpha: AES-S = 0.86; AES-I = 0.94; AES-C = 0.90.
Statistical methods used to assess reliability: Validity: Content validity: not available in reviewed references Construct validity: not available in reviewed references.
Convergent validity: Intercorrelations among the three scales (AES-S, AES-I, AES-C):
AES-C and AES-I: r = 0.62; AES-C and AES-S: r = 0.72; AES-S and AES-I: r = 0.43.
Sensitivity to Change/ Ability to Detect Change (over time or in response to an intervention): Not available in reviewed references.
Known Relationships to Other Variables: Depression and use of medication (especially neuroleptics, antidepressants, and benzodiazepines) are related to apathy.
Diagnostic Sensitivity and Specificity, if applicable: Not available in reviewed references.
Strengths: This instrument assesses multiple aspects of apathy and has been used in a variety of neuropsychiatric disorders, and allows for comparison between patient/self, informant, and clinician reports.
Weaknesses: The AES may not discriminate apathy from depression.
Key References:
Marin RS. Differential diagnosis and classification of apathy. Am J Psychiatry. 1990 Jan;147(1):22-30.
Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res. 1991 Aug;38(2):143-62.
NeuroRehab-Specific Reference:
Raimo S, Trojano L, Spitaleri D, Petretta V, Grossi D, Santangelo G. Apathy in multiple sclerosis: a validation study of the apathy evaluation scale. J Neurol Sci. 2014 Dec 15;347(1-2):295-300.
Document last updated March 2024