Apathy and physical activity: A systematic review and meta-analysis

PurposePatient motivation is essential for the success of their rehabilitation. Apathy, a state of primary motivational deficiency, may therefore hinder physiotherapists interventions, such as those aimed at increasing patients physical activity. This study aims to examine the relationship between apathy and physical activity and to identify the factors that influence this relationship. MethodsSix databases were searched for articles including both a measure of apathy and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between apathy and physical activity. Subgroup meta-analyses were conducted to examine the differences between studies that included participants with different health conditions and used different types of physical activity outcomes and apathy measures. Meta-regressions were conducted to examine the moderating effects of age and gender. ResultsTwenty-eight articles were included in the systematic review and 22 studies (n = 12,541 participants) in the main meta-analysis. Results showed a negative correlation between apathy and physical activity (r = -0.13; 95% CI: -0.18 to -0.09; p < 0.0001 based on Pearsons r values; r = - 0.40; 95% CI: -0.68 to -0.02; p = 0.043 based on Spearmans rho values). A subgroup meta-analysis revealed that the correlation was statistically significant in patients with Parkinsons disease and in older adults who were healthy, depressed, fallers, or had mild cognitive impairment. A meta-regression showed an effect of age, with a stronger correlation between apathy and physical activity in older adults compared to younger adults (p = 0.003). ConclusionOur results suggest that higher levels of apathy are associated with lower levels of physical activity and that this negative association is stronger with age. Therefore, apathy may limit exercise therapy efficacy and carry prognostic implications for patients whose condition requires physical activity.