{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T14:37:26Z","timestamp":1788014246139,"version":"build-2784847793"},"reference-count":112,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Apathy is among the most common neuropsychiatric features of late-life neurocognitive disorders and predicts functional decline and greater caregiver burden. As no treatment is formally established, identifying effective interventions is a priority. We systematically reviewed non-pharmacological randomized controlled trials (RCTs) targeting apathy in older adults with neurocognitive disorders. Methods: We searched PubMed\/MEDLINE, PsycInfo, the Cochrane Library, and Google Scholar (final search 23 March 2026). Eligible studies were non-pharmacological RCTs reporting an apathy outcome. Evidence levels were graded with OCEBM and quality with PEDro; two reviewers mapped PEDro items onto Cochrane risk-of-bias domains. Reporting followed PRISMA 2020. Results: Sixty-two RCTs were included. Physical exercise and music-based interventions showed the most consistent benefit, whereas technology-based and brain stimulation approaches remained experimental. Only 30 trials (48%) showed a significant between-group effect on apathy\u2014most were null, within-group, or had apathy as a secondary outcome. Marked heterogeneity precluded meta-analysis. Most trials were of moderate to high quality, though near-universal performance bias arose from the inability to blind participants and providers. Conclusions: Managing apathy in these populations remains challenging, and the certainty of the evidence is limited. Purpose-built, apathy-focused trials reporting effect sizes and durability are needed before disease-specific recommendations can be made.<\/jats:p>","DOI":"10.3390\/brainsci16070687","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:58:04Z","timestamp":1782799084000},"page":"687","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Non-Pharmacological Interventions for Managing Apathy in Older Adults with Neurocognitive Disorders: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3366-2989","authenticated-orcid":false,"given":"Kostas","family":"Siarkos","sequence":"first","affiliation":[{"name":"Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-7517","authenticated-orcid":false,"given":"Antonios M.","family":"Politis","sequence":"additional","affiliation":[{"name":"Psychogeriatric Unit, First Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, 74 Vas. Sofias Ave., 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6899-1937","authenticated-orcid":false,"given":"Anastasios A.","family":"Politis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neurotraumatology, Athens Medical School, \u2018Attikon\u2019 University General Hospital, National and Kapodistrian University, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1461-6151","authenticated-orcid":false,"given":"Nikolaos","family":"Smyrnis","sequence":"additional","affiliation":[{"name":"Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalambos","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Precision Medicine Research Institute \u201cCostas Stefanis\u201d, University Mental Health Neurosciences, 15601 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9194-2447","authenticated-orcid":false,"given":"Andreas","family":"Prentakis","sequence":"additional","affiliation":[{"name":"Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0362-1681","authenticated-orcid":false,"given":"Rossetos","family":"Gournellis","sequence":"additional","affiliation":[{"name":"Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everina","family":"Katirtzoglou","sequence":"additional","affiliation":[{"name":"Psychogeriatric Unit, First Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, 74 Vas. Sofias Ave., 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7313-6908","authenticated-orcid":false,"given":"Christos","family":"Theleritis","sequence":"additional","affiliation":[{"name":"Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon Hospital, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"s10","DOI":"10.1212\/WNL.48.5_Suppl_6.10S","article-title":"The Neuropsychiatric Inventory: Assessing Psychopathology in Dementia Patients","volume":"48","author":"Cummings","year":"1997","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1212\/WNL.46.1.130","article-title":"The Spectrum of Behavioral Changes in Alzheimer\u2019s Disease","volume":"46","author":"Mega","year":"1996","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1001\/jama.288.12.1475","article-title":"Prevalence of Neuropsychiatric Symptoms in Dementia and Mild Cognitive Impairment: Results from the Cardiovascular Health Study","volume":"288","author":"Lyketsos","year":"2002","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1176\/appi.ajp.157.5.708","article-title":"Mental and Behavioral Disturbances in Dementia: Findings from the Cache County Study on Memory in Aging","volume":"157","author":"Lyketsos","year":"2000","journal-title":"Am. 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