scholarly journals Apathy and functional disability in behavioral variant frontotemporal dementia

2018 ◽  
Vol 8 (2) ◽  
pp. 120-128 ◽  
Author(s):  
Mônica S. Yassuda ◽  
Thais B. Lima da Silva ◽  
Claire M. O'Connor ◽  
Shailaja Mekala ◽  
Suvarna Alladi ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Functional Impairment ◽  
Cognitive Deficits ◽  
Daily Living ◽  
Functional Disability ◽  
Motor Behavior ◽  
Regression Analyses ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Everyday Function

BackgroundBehavioral variant frontotemporal dementia (bvFTD) has profound consequences on patients and their families. In this multicenter study, we investigated the contribution of cognitive and neuropsychiatric factors to everyday function at different levels of overall functional impairment.MethodsIn a retrospective cross-sectional study, 109 patients with bvFTD from 4 specialist frontotemporal dementia centers (Australia, England, India, and Brazil) were included. The measures administered evaluated everyday function (Disability Assessment for Dementia [DAD]), dementia staging (Clinical Dementia Rating [CDR]), general cognition (Addenbrooke's Cognitive Examination–revised [ACE-R]), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). Patients were then subdivided according to functional impairment on the DAD into mild, moderate, severe, and very severe subgroups. Three separate multiple linear regression analyses were run, where (1) total DAD, (2) basic activities of daily living (BADL), and (3) instrumental activities of daily living (IADL) scores were dependent variables; ACE-R total score and selected NPI domains (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) were used as independent variables. Age, sex, education, and country of origin were controlled for in the analyses.ResultsCognitive deficits were similar across the mild, moderate, and severe subgroups but significantly worse in the very severe subgroup. NPI domain scores (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) did not differ across the DAD subgroups. In the multiple regression analyses, a model including ACE-R and NPI apathy explained 32.5% of the variance for total DAD scores. For IADL, 35.6% of the variance was explained by the ACE-R only. No model emerged for BADL scores.ConclusionsCognitive deficits and apathy are key contributors to functional disability in bvFTD but factors underlying impairment in BADLs remain unclear. Treatments targeting reduction of disability need to address apathy and cognitive impairment to ensure greater efficacy, especially in regards to IADLs.

Neural Correlates of Activities of Daily Living in Frontotemporal Dementia

2013 ◽  
Vol 26 (1) ◽  
pp. 51-57 ◽  
Author(s):  
E. Mioshi ◽  
J. R. Hodges ◽  
M. Hornberger
Keyword(s):  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Gray Matter ◽  
Daily Living ◽  
Functional Disability ◽  
Neural Correlates ◽  
Voxel Based Morphometry ◽  
Tailored Interventions ◽  
Gray Matter Atrophy ◽  
Patient Groups

Background: Little research to date has investigated neural correlates of functional disability in frontotemporal dementia (FTD). Methods: Activities of daily living (ADL) were covaried against gray matter atrophy regions via Voxel-based morphometry in FTD (n = 52) and contrasted against a dementia control Alzheimer disease (AD) group (n = 20) and healthy age-matched controls (n = 18). Results: Both patient groups had similar ADL scores. However, FTD and AD differed on the gray matter atrophy areas associated with ADL scores. The FTD showed involvement of prefrontal and thalamus regions while AD showed widespread temporal, parietal, frontal, and caudate atrophy correlating with ADL dysfunction. Importantly, only the left superior frontal gyrus was implicated in ADL dysfunction for both FTD and AD. Conclusions: Differences in underlying neural correlates of ADL impairment have important clinical implications as these differences should be taken into account when interventions are planned. Dementia subtypes might require specifically tailored interventions for functional disability.

scholarly journals Caregiver Burden in Semantic Dementia with Right- and Left-Sided Predominant Cerebral Atrophy and in Behavioral-Variant Frontotemporal Dementia

2018 ◽  
Vol 8 (1) ◽  
pp. 128-137 ◽  
Author(s):  
Asuka Koyama ◽  
Mamoru Hashimoto ◽  
Ryuji Fukuhara ◽  
Naoko Ichimi ◽  
Akihiro Takasaki ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Caregiver Burden ◽  
Daily Living ◽  
Psychological Symptoms ◽  
Cerebral Atrophy ◽  
Japanese Version ◽  
Semantic Dementia ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Significant Difference

Background: Caregiver burden is a serious concern for family caregivers of dementia patients, but its nature is unclear in patients with semantic dementia (SD). This study aimed to clarify caregiver burden for right- (R > L) and left-sided (L > R) predominant SD versus behavioral-variant frontotemporal dementia (bvFTD) patients. Methods: Using the Japanese version of the Zarit Burden Interview (ZBI) and the Neuropsychiatric Inventory, we examined caregiver burden and behavioral and psychological symptoms of dementia (BPSD) in 43 first-visit outpatient/family caregiver dyads (bvFTD, 20 dyads; SD [L > R], 13 dyads; SD [R > L], 10 dyads). Results: We found a significant difference in ZBI score between the 3 diagnostic groups. Post hoc tests revealed a significantly higher ZBI score in the bvFTD than in the SD (L > R) group. The ZBI scores in the SD (L > R) and SD (R > L) groups were not significantly different, although the effect size was large. Caregiver burden was significantly correlated with BPSD scores in all groups and was correlated with activities of daily living and instrumental activities of daily living decline in the bvFTD and SD (R > L) groups. Conclusion: Caregiver burden was highest in the bvFTD group, comparatively high in the SD (R > L) group, and lowest in the SD (L > R) group. Adequate support and intervention for caregivers should be tailored to differences in caregiver burden between these patient groups.

Direct and Indirect Assessments of Activities of Daily Living in Behavioral Variant Frontotemporal Dementia and Alzheimer Disease

2014 ◽  
Vol 28 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Thais Bento Lima-Silva ◽  
Valéria Santoro Bahia ◽  
Viviane Amaral Carvalho ◽  
Henrique Cerqueira Guimarães ◽  
Paulo Caramelli ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Daily Living ◽  
Behavioral Variant Frontotemporal Dementia

scholarly journals Apathy, Executive Function, and Emotion Recognition Are the Main Drivers of Functional Impairment in Behavioral Variant of Frontotemporal Dementia

2022 ◽  
Vol 12 ◽  
Author(s):  
Gada Musa Salech ◽  
Patricia Lillo ◽  
Karin van der Hiele ◽  
Carolina Méndez-Orellana ◽  
Agustín Ibáñez ◽  
...  
Keyword(s):  
Executive Function ◽  
Activities Of Daily Living ◽  
Emotion Recognition ◽  
Frontotemporal Dementia ◽  
Functional Impairment ◽  
Daily Living ◽  
Early Stage ◽  
Neuropsychiatric Symptoms ◽  
Functional Domain ◽  
The Impact

Background: The cognitive and neuropsychiatric deficits present in patients with behavioral variant frontotemporal dementia (bvFTD) are associated with loss of functionality in the activities of daily living (ADLs). The main purpose of this study was to examine and explore the association between the cognitive and neuropsychiatric features that might prompt functional impairment of basic, instrumental, and advanced ADL domains in patients with bvFTD.Methods: A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (<2 years of evolution) and 32 healthy control subjects. A neuropsychological assessment was carried out wherein measures of cognitive function and neuropsychiatric symptoms were obtained. The informant-report Technology–Activities of Daily Living Questionnaire was used to assess the percentage of functional impairment in the different ADL domains. To identify the best determinants, three separate multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, emotion recognition, disinhibition, and apathy as independent variables.Results: For the basic ADLs, a model that explains 28.2% of the variability was found, in which the presence of apathy (β = 0.33, p = 0.02) and disinhibition (β = 0.29, p = 0.04) were significant factors. Concerning instrumental ADLs, the model produced accounted for 63.7% of the functional variability, with the presence of apathy (β = 0.71, p < 0.001), deficits in executive function (β = −0.36, p = 0.002), and lack of emotion recognition (β = 0.28, p = 0.017) as the main contributors. Finally, in terms of advanced ADLs, the model found explained 52.6% of the variance, wherein only the presence of apathy acted as a significant factor (β = 0.59, p < 0.001).Conclusions: The results of this study show the prominent and transverse effect of apathy in the loss of functionality throughout all the ADL domains. Apart from that, this is the first study that shows that the factors associated with loss of functionality differ according to the functional domain in patients with bvFTD in its early stage. Finally, no other study has analyzed the impact of the lack of emotion recognition in the functionality of ADLs. These results could guide the planning of tailored interventions that might enhance everyday activities and the improvement of quality of life.

Analysis of Functional and Cognitive Impairment in Institutionalized Individuals with Movement Disorders

2019 ◽  
Vol 19 (7) ◽  
pp. 1022-1031 ◽  
Author(s):  
Paula D. Cebrián ◽  
Omar Cauli
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Cognitive Performance ◽  
Functional Impairment ◽  
Movement Disorders ◽  
Neurological Disorders ◽  
Daily Living ◽  
Severe Cognitive Impairment

Background: Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations. Objective: We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson’s disease, Alzheimer’s disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems. Methods: All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale. Results: The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson’s disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment. Conclusion: In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.

Who cares? Provision of Care and Assistance Among Older Persons in the Philippines

2018 ◽  
Vol 30 (10) ◽  
pp. 1536-1555 ◽  
Author(s):  
Jeofrey B. Abalos ◽  
Yasuhiko Saito ◽  
Grace T. Cruz ◽  
Heather Booth
Keyword(s):  
Activities Of Daily Living ◽  
Older Women ◽  
Daily Living ◽  
Older Persons ◽  
Older Men ◽  
The Philippines ◽  
Regression Analyses ◽  
Functional Activities ◽  
Provision Of Care ◽  
Experience Difficulty

Objective: This study aims to examine the provision of assistance among older persons in the Philippines who experience difficulty with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Method: Data for this research are drawn from the 2007 Philippine Study on Aging (PSOA). Cross-tabulations and regression analyses are used to identify who provides assistance to older Filipinos. Results: The study shows that the Filipino family, particularly spouse and daughters, plays an important role in providing assistance to older Filipinos who need help in carrying out functional activities. This provision of caregiving, however, follows a gendered pattern. Specifically, the spouse provides assistance to older men, whereas daughters provide assistance to older women. Grandchildren and noncoresident family members, to some extent, are also active in providing care to older Filipinos. Discussion: The Filipino family remains faithful to its filial duty toward older persons, but who provides care and the way it is provided are likely to change due to the demographic changes and values shifts that have swept the country.

Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study

2020 ◽  
Author(s):  
Lizhi Guo ◽  
Li An ◽  
Fengping Luo ◽  
Bin Yu
Keyword(s):  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Social Isolation ◽  
Daily Living ◽  
Functional Disability ◽  
Iadl Disability ◽  
Older Populations ◽  
New Onset

Abstract Objective This study investigated whether loneliness or social isolation is associated with the onset of functional disability over 4 years among Chinese older populations. Setting and Subjects This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Analyses were conducted with data from two waves (2011 and 2015) and were restricted to those respondents aged 50 and older and free of functional disability at baseline [n = 5,154, mean age (SD) = 60.72 (7.51); male, 52.3%]. Method Social isolation, loneliness and covariates were measured at baseline. Follow-up measures of new-onset ADL and IADL disability were obtained 4 years later. We stratified the sample by gender, and then used binary logistic regressions to evaluate the associations between baseline isolation, loneliness and new-onset ADL and IADL disability. Results For women, baseline social isolation was significantly associated with new-onset ADL (OR = 1.18, 95% CI = 1.07–1.30) and IADL (OR = 1.11, 95% CI = 1.01–1.21) disability; no significant association between loneliness and ADL or IADL disability was found. For men, neither social isolation nor loneliness was found to be significantly associated with ADL or IADL disability. Conclusion This longitudinal study found that social isolation, rather than loneliness, was significantly associated with functional disability over 4 years among women (but not men) in China. These findings expand our knowledge about the association between social relationships and functional status among non-Western populations.

scholarly journals Socio-economic inequality in functional disability and impairments with focus on Instrumental Activity of Daily Living: A Study on Older Adults in India

2021 ◽  
Author(s):  
Ratna Patel ◽  
Shobhit Srivast ◽  
Pradeep Kumar ◽  
SHEKHAR CHAUHAN ◽  
Mani Deep Govindu ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Population Aging ◽  
Economic Inequality ◽  
National Level ◽  
Memory Loss ◽  
Decomposition Analysis ◽  
The Government

Abstract Background Studies have examined functional disability among older adults by combining Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). This study adds another dimension to ADL and IADL by combining various impairments such as hearing, vision, walking, chewing, speaking, and memory loss among older adults. This study examines functional disability among older adults in India as measured by ADL, IADL, along with various impairments. Methods This study utilized data from Building a Knowledge Base on Population Aging in India (BKPAI), a national-level survey and conducted across seven states of India. The study utilized three outcome variables, namely, ADL, IADL, and Impairments. Descriptive and bivariate analyses were used along with multivariate analysis to fulfill the objectives of the study. The concentration index was calculated for ADL, IADL, and impairments, and further, decomposition analysis was carried out for IADL. Results The results observed that nearly 7.5 percent of older adults reported ADL, more than half (56.8%) reported IADL, and nearly three-fourths (72.6%) reported impairments. Overall, ADL, IADL, and impairments were higher among older adults aged 80 + years, older adults with poor self-rated health, and those suffering from chronic diseases. Educational status and wealth explained most of the socio-economic inequality in the prevalence of IADL among older adults. Conclusion It is recommended that the government advise older adults to adopt health-promoting approaches, which may be useful. Further, there is a pressing need to deliver quality care to older adults suffering from chronic conditions.

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