Apathy study funded by Alzheimer’s Association

Prasad Padala, M.D.

Prasad Padala, M.D., assistant professor of psychiatry at UNMC and a staff psychiatrist at the VA Nebraska-Western Iowa Health Care System, received a New Investigator Research Grant from the Alzheimer’s Association, the leading voluntary health organization in Alzheimer care, support and research.

The two-year $98,690 grant that begins Jan. 1, will allow Dr. Padala to study apathy in patients with comorbid diabetes and dementia. He will investigate if the quality of life, functional status and glycemic control improve by treating apathy and motivating these patients.

As part of the UNMC Clinical and Translational Research Mentored Scholars program, Dr. Padala will work under the direction of William Burke, M.D., professor and vice chairman of psychiatry, and the primary mentor on this grant. Dr. Burke also is the director of the division of geriatric psychiatry, and heads the Psychopharmacology Research Consortium.

“Participation in the mentored scholar’s program and mentoring by Dr. Burke has clearly helped me pursue a focused research question and helped me hone my writing skills.” Prasad Padala, M.D.

Also helping Dr. Padala complete the study will be Jennifer Larsen, M.D., the Degan professor and associate dean for clinical research in the College of Medicine; Jane Potter, M.D., the Neuman and Mildred Harris professor and section chief, geriatrics; and Cyrus Desouza, M.D., associate professor, endocrinology; and Frederick Petty, M.D., Ph.D., Creighton University Medical Center’s department of psychiatry vice-chairman of research.

“Participation in the mentored scholar’s program and mentoring by Dr. Burke has clearly helped me pursue a focused research question and helped me hone my writing skills,” Dr. Padala said.

Apathy is the most common behavioral problem in patients with Alzheimer’s disease, affecting up to 90 percent of patients. Apathy is characterized by loss of initiative and motivation, decreased social engagement and emotional indifference.

Diabetes mellitus type 2 is an established risk factor for Alzheimer’s disease. Hence, there are many individuals with both conditions. Presence of apathy complicates the management of both diabetes and dementia leading to rapid decline in cognition, poor control of blood sugars and poor quality of life.

Dr. Padala and colleagues have conducted small studies of the drug methylphenidate in patients with both Alzheimer’s disease and diabetes. They have found evidence that such treatment reduces apathy, which motivates patients to improve their glycemic control and other aspects of health care and quality of life. Because studies to date have not been blinded or placebo-controlled, the results are not definitive.

Dr. Padala and colleagues plan to conduct a double-blind, placebo-controlled trial of methylphenidate in people with Alzheimer’s disease and diabetes. They plan to measure apathy using validated scales, as well as glycemic control, cognitive function, functional status and quality of life. This study may help determine if methylphenidate is an effective treatment for apathy in people with Alzheimer’s disease and diabetes.