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Lille%20Apathy%20Rating%20Scale%20(LARS)
Lille%20Apathy%20Rating%20Scale%20(LARS)
| Availability |
Please visit this website for more information about the instrument: Lille Apathy Rating Scale
This instrument is available in English as a supplement to the paper (Sockeel et al., 2006). Additional versions are freely available for non-profit research.
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| Classification |
Supplemental - Highly Recommended: Parkinson's Disease (PD)
Recommendations for use: Indicated for studies requiring a clinician rated measure of apathy.
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| Short Description of Instrument |
The Lille Apathy Rating Scale (LARS) is a structured, standardized interview questionnaire designed to distinguish between the various features of apathy. It allows detection of the syndrome and assessment of symptoms severity. Several versions of the scale have been validated: originally, a version based on an interview with the patient (Sockeel et al., 2006), one based on an interview with an informant for patients with cognitive disorders or unaware of their symptoms (Dujardin et al., 2008; LARS-i). A short form (sf-LARS) was also validated for screening apathy in everyday practice (Dujardin et al., 2013).
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| Comments/Special Instructions |
The LARS was created from the theoretical basis of the Marin's apathy evaluation scale (AES). It is a 33-item questionnaire divided into nine domains. Eight of the domains focus on the clinical manifestations of apathy, which is described as reduction in everyday productivity; lack of interest; lack of initiative; extinction of novelty seeking and motivation; blunting of emotional responses; lack of concern; and poor social life. The ninth domain focuses on extinction of self-awareness (Sockeel et al., 2006). There are 4 subscales.
The LARS is in good agreement with the criteria for clinical diagnosis of apathy (Robert et al., 2009).
Administration takes about 10 minutes for the complete version and 5 minutes for the short-form scale of 15 items.
The LARS is available in different languages (see https://eprovide.mapi-trust.org/instruments/lille-apathy-rating-scale)
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| Scoring and Psychometric Properties |
Response is based on the past 4 weeks. The first three questions of the questionnaire are coded on a five-point Likert type scale (2,1,0,-1,-2). Other questions have a binary quotation. The nine domains are evaluated through subscales which contribute equal weight to the global score. The global score ranges from -36 to +36 with higher scores representing greater degrees of apathy (Sockeel et al., 2006). In Parkinson's disease, a clinimetric approach showed the cut-off scores are -22/-21 for mild, -17/-16 for moderate and -10/-9 for severe apathy. The cut-off score of > -16 for diagnostic apathy had good accuracy index=0.91; k=0.79, sensitivity (0.89) and specificity (0.92) (Sockeel et al., 2006).
Total LARS score correlated positively with the Apathy Evaluation Scale (AES) overall score (r = 0.87), internal consistency was good (Cronbach's alpha=0.80 for between items and subscales alpha=0.74), and inter-rater reliability was good (ICC=0.98) (Sockeel et al., 2006).
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| Rationale/Justification |
Strengths: Good psychometrics and clinimetrics.
Weaknesses: Clinician administered structure interview, which may not be practical in some settings. May not distinguish from depression.
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| References |
Key Reference:
Sockeel P, Dujardin K, Devos D, Denève C, DestÉe A, Defebvre L. The Lille apathy rating scale (LARS), a new instrument for detecting and quantifying apathy: validation in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2006 May;77(5):579-84.
Additional References:
Dujardin K, Sockeel P, Carette AS, Delliaux M, Defebvre L. Assessing apathy in everyday clinical practice with the short-form Lille Apathy Rating Scale. Mov Disord. 2013 Dec;28(14):2014-9.
Dujardin K, Sockeel P, Delliaux M, DestÉe A, Defebvre L. The Lille Apathy Rating Scale: validation of a caregiver-based version. Mov Disord. 2008 Apr 30;23(6):845-9.
Robert P, Onyike CU, Leentjens AF, Dujardin K, Aalten P, Starkstein S, Verhey FR, Yessavage J, Clement JP, Drapier D, Bayle F, Benoit M, Boyer P, Lorca PM, Thibaut F, Gauthier S, Grossberg G, Vellas B, Byrne J. Proposed diagnostic criteria for apathy in Alzheimer's disease and other neuropsychiatric disorders. Eur Psychiatry. 2009 Mar;24(2):98-104.
Document last updated August 2022
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