In major chronic diseases, apathy or impaired executive cognitive
function (ECF) can reduce the patient's ability to cope with the disease
and its treatment and to maintain personal safety, dignity, and
goal-directed activity. Psychometric and imaging studies support a causal
role for frontal system dysfunction. The view that frontal system
dysfunction mediates or aggravates disability in a wide range of
psychiatric and nonpsychiatric disorders 1) motivates further research on
how ECF deficits interact with specific physical impairments to produce
disability; 2) supports policies that base entitlements to care on ECF
impairments; and 3) suggests the need for a vigorous search for drugs that
prevent or palliate prefrontal dysfunction, especially the syndromes of
apathy and impaired ECF.Abstract Teaser