The Association Between Characteristics of Care Environments and Apathy in Residents With Dementia in Long-term Care Facilities

Gerontologist. 2015 Jun;55 Suppl 1:S27-39. doi: 10.1093/geront/gnu166.


Purpose: Apathy is highly prevalent in dementia but often overlooked. Environment-based interventions have demonstrated positive impact on apathy, yet, influential environmental components are largely understudied. This study examined the relationship between care environments and apathy in long-term care residents with dementia.

Design and methods: This study was exploratory and employed a descriptive and repeated observation design. A sample of 40 was selected from a parent study with 185 participants from 28 facilities. Three videos from each participant were coded to measure apathy and environmental stimulation. Data on ambiance, crowding, staff familiarity, light, and sounds were extracted from the parent study. Generalized linear mixed models were used for analysis.

Results: The clarity and strength of environmental stimulation were significantly associated with a lower apathy level. An increase of 1 point on stimulation clarity and strength corresponded to a decrease of 1.3 and 1.9 points on apathy score, respectively (p < .0001). Other environmental factors did not show significant effect on apathy.

Implications: This study explored influential environmental features on apathy in dementia. Findings suggest that care environments that contain clear and sufficient environmental stimulation are significantly associated with lower resident apathy levels. Findings will guide environmental design and interventions for dementia care.

Keywords: Alzheimer’s disease; Assisted living; Neuropsychiatric symptoms; Nursing homes,.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Apathy*
  • Assisted Living Facilities*
  • Dementia / nursing*
  • Environment
  • Female
  • Humans
  • Long-Term Care*
  • Male
  • Middle Aged
  • Nursing Homes
  • Quality of Life