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We systematically quantified discrepancies between self- and caregiver-reported apathy in 335 patients with a variety of diagnoses, such as frontotemporal dementia (behavioural variant and semantic dementia subtypes), Parkinson\u2019s disease, Parkinson\u2019s disease dementia, dementia with Lewy bodies, Alzheimer\u2019s disease dementia, mild cognitive impairment, small vessel cerebrovascular disease, subjective cognitive decline and autoimmune encephalitis. Using the Apathy Motivation Index (AMI) and its analogous caregiver version (AMI-CG), we found that caregiver-reported apathy consistently exceeded self-reported levels across all conditions. Moreover, self-reported apathy accounted for only 14.1% of the variance in caregiver ratings. This apathy reporting discrepancy was most pronounced in conditions associated with impaired insight, such as behavioural variant frontotemporal dementia, and was significantly correlated with cognitive impairment. Deficits in memory and fluency explained an additional 11.2% of the variance in caregiver-reported apathy. Specifically, executive function deficits (e.g. indexed by fluency) and memory impairments may contribute to behavioural inertia or recall of it. These findings highlight the need to integrate patient and caregiver perspectives in apathy assessments, especially for conditions with prominent cognitive impairment. To improve diagnostic accuracy and deepen our understanding of apathy across neurological disorders, we highlight the need for adapted apathy assessment strategies that account for cognitive impairment particularly in individuals with insight or memory deficits. Understanding the cognitive mechanisms underpinning discordant apathy reporting in dementia might help inform targeted clinical interventions and reduce caregiver burden.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaf235","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T07:47:05Z","timestamp":1749714425000},"source":"Crossref","is-referenced-by-count":11,"title":["Self- versus caregiver-reported apathy across neurological disorders"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6246-0702","authenticated-orcid":false,"given":"Sijia","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Experimental Psychology, University of Oxford , Oxford OX2 6GG ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Scholcz","sequence":"additional","affiliation":[{"name":"Department of Experimental Psychology, University of Oxford , Oxford OX2 6GG ,","place":["UK"]},{"name":"Cognitive Disorders Clinic, John Radcliffe Hospital , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-4301","authenticated-orcid":false,"given":"Matthew A","family":"Rouse","sequence":"additional","affiliation":[{"name":"MRC Cognition and Brain Sciences Unit, University of Cambridge , Cambridge CB2 7EF ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena S","family":"Klar","sequence":"additional","affiliation":[{"name":"Department of Experimental Psychology, University of Oxford , Oxford OX2 6GG ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4828-8117","authenticated-orcid":false,"given":"Akke","family":"Ganse-Dumrath","sequence":"additional","affiliation":[{"name":"Department of Experimental Psychology, University of Oxford , Oxford OX2 6GG ,","place":["UK"]},{"name":"Cognitive Disorders Clinic, John Radcliffe Hospital , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1833-4995","authenticated-orcid":false,"given":"Sofia","family":"Toniolo","sequence":"additional","affiliation":[{"name":"Cognitive Disorders Clinic, John Radcliffe Hospital , Oxford OX3 9DU ,","place":["UK"]},{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M John","family":"Broulidakis","sequence":"additional","affiliation":[{"name":"Department of Experimental Psychology, University of Oxford , Oxford OX2 6GG ,","place":["UK"]},{"name":"Cognitive Disorders Clinic, John Radcliffe Hospital , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5907-2488","authenticated-orcid":false,"given":"Matthew A","family":"Lambon Ralph","sequence":"additional","affiliation":[{"name":"MRC Cognition and Brain Sciences Unit, University of Cambridge , Cambridge CB2 7EF ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B","family":"Rowe","sequence":"additional","affiliation":[{"name":"MRC Cognition and Brain Sciences Unit, University of Cambridge , Cambridge CB2 7EF ,","place":["UK"]},{"name":"Department of Clinical Neurosciences, University of Cambridge , Cambridge CB2 0QQ ,","place":["UK"]},{"name":"Cambridge University Hospitals NHS Foundation Trust , Cambridge CB2 0QQ 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