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The Apathy Evaluation Scale’s Scoring for Individuals with Traumatic Brain Injury Appears Questionable

Categories: Cognitive Assessments - Thinking and Emotional Skills

The Question

What scores on the Apathy Evaluation Scale are indicative of apathy for individuals with traumatic brain injury and are in agreement with the findings of clinicians?

Past Studies

Past Studies state that it is common for individuals with traumatic brain injury to experience apathy as a result of neurological changes. Apathetic individuals can have a lack of motivation and a decrease in thought processing and physical activity levels. Apathy is characterized by a decline in goal-directed activity, a reduction in goal-related thoughts, and the absence of emotional reactions. Traditionally, apathy has not been associated with being caused by a lowered level of consciousness, thought processing problems, or emotional distress. In some individuals, it can be difficult to tell apathy apart from depression because they can appear to be similar. Characteristics of depression include continual feelings of sadness, irritability, tiredness, and a lack of interest in activities that were once enjoyable. Other common symptoms of depression include having difficulty getting a good night’s sleep, moving the body at a much slower pace, and not being able to remember things or concentrate as easily as before. The Apathy Evaluation Scale (AES) has been used by clinicians to determine the presence of apathy in individuals with Alzheimer’s disease, stroke, depression, and traumatic brain injury. The AES can be given to individuals, their significant others, and their clinicians to compare responses. Although the AES has been used with individuals with traumatic brain injuries, clinicians question what scores on the AES indicate that apathy is present. Although apathy can interfere with an individual’s efforts in rehabilitation, little research has been conducted on this subject. 

This Study      

This Study attempted to determine scores on the Apathy Evaluation Scale (AES) that indicated apathy was present in individuals with traumatic brain injury. Another goal of this study was to determine the likelihood of the AES to show that people with apathy had apathy and that individuals without apathy did not have apathy. To do so, the researchers tested 45 outpatients primarily with mild traumatic brain injuries with the AES. The AES was also given to 35 of the individuals’ significant others. The individuals’ clinicians were then asked if the individuals had apathy or not. Further, the clinicians used a separate apathy scale created by the researchers to rate the degree to which they believed that apathy was present.After analyzing the data, the researchers were unable to state specifically what scores on the AES indicated that the individuals in this study had apathy. The study results showed that the clinicians made good judgments about which participants had apathy or not, but that the AES test scores did not indicate this. Because the researchers were not able to state what AES scores agreed with the clinician’s findings of the presence or absence of apathy, they therefore could not use the AES scores to state the prevalence of apathy in the participants.

Who May Be Affected By These Findings

Healthcare providers who use and interpret the AES, individuals with traumatic brain injury and their significant others, researchers


The researchers used a broader definition of apathy for this study that included the definition of depression. They question what influence this had on their results.

Bottom Line

The researchers were not able to determine what scores on the Apathy Evaluation Scale (AES) showed that individuals with traumatic brain injury had apathy. The researchers were unable to show what scores on the AES would predict the clinicians’ findings of apathy. The AES appears to require further study if it is to be used to measure apathy following traumatic brain injury.

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Find This Study


Glenn, M.B., Burke, D.T., O’Neil-Pirozzi, T., Goldstein, R., Jacob, L., & Kettell, J. (2002). Cutoff score on the apathy evaluation scale in subjects with traumatic brain injury. Brain Injury, 16, 509-516.

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