TUESDAY, July 13 (HealthDay News) -- Patients with Alzheimer's
disease often can seem withdrawn and apathetic, symptoms frequently
attributed to memory problems or difficulty finding the right
words.
But patients with the progressive brain disorder may also have a
reduced ability to experience emotions, a new study suggests.
When researchers from the University of Florida and other
institutions showed a small group of Alzheimer's patients 10
positive and 10 negative pictures, and asked them to rate them as
pleasant or unpleasant, they reacted with less intensity than did
the group of healthy participants.
"For the most part, they seemed to understand the emotion [normally evoked from the picture they were looking at]," said Dr. Kenneth Heilman, senior author of the study and a professor of neurology at the University of Florida's McKnight Brain Institute. But, he added, their reactions were different from those of the healthy participants.
"Even when they comprehended the scene, their emotional reaction was very blunted," he said. The study is published online in the Journal of Neuropsychiatry and Clinical Neurosciences.
The study participants -- seven with Alzheimer's and eight
without -- made a mark on a piece of paper that had a happy face on
one end and a sad one on the other, putting the mark closer to the
happy face the more pleasing they found the picture and closer to
the sad face the more distressing.
Compared to the healthy participants, those with Alzheimer's
found the pictures less intense.
They didn't find the pleasant pictures (such as babies and
puppies) as pleasant as did the healthy participants. They found
the negative pictures (snakes, spiders) less negative.
"If you have a blunted emotion, people will say you look withdrawn," Heilman said.
One important take-home message, he added, is for families and
physicians not to automatically think a patient with blunted
emotions is depressed and ask for or prescribe antidepressants
without a thorough evaluation first.
Exactly why this blunting of emotions may occur isn't known,
Heilman said. He speculates there may be a degradation of part of
the brain or loss of control of part of the brain important for
experiencing emotion. Or a neurotransmitter important for
experiencing emotion may undergo degradation.
What the finding suggests is that as the memory goes, so does
some emotion, said Dr. Gary Kennedy, a geriatric psychiatrist at
Montefiore Medical Center in New York City, who reviewed the
findings.
"Emotion and memory go together," he said. "The more emotion you can attach to an event, the more likely you are to remember. I think what this paper is telling us is that the disease is causing the emotional response to become more and more shallow over time."
Apathy seen in Alzheimer's patients is often reported by family
members, Kennedy said. "Apathy is a heartbreaker for the family,"
he said.
Even so, both Kennedy and Heilman had a positive message for
family members. For family, it's not to take it personally if a
loved one with Alzheimer's is apathetic. "Don't interpret it as
being done willfully," Kennedy said.
Heilman said families can try to make information more explicit
when talking to those with Alzheimer's, in an effort to help
emotions kick in. If you show a loved one a picture, for instance,
give verbal details about the person or object in it, he suggested.
You may see less apathy in response.
The research was supported in part by Lundbeck Pharmaceutical
Co., whose products include Alzheimer's medicine.
More information
To learn more about the stage of Alzheimer's disease, visit the
Alzheimer's Association.