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Effectiveness of Pharmacological Interventions for Symptoms of Behavioral Variant Frontotemporal Dementia. Cogn Behav Neurol 2020; 33:1-15. [DOI: 10.1097/wnn.0000000000000217] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Martins LT, Teixeira IA, Laks J, Marinho V. Recognizing Late Onset Frontotemporal Dementia with the DAPHNE scale: A case report. Dement Neuropsychol 2018; 12:75-79. [PMID: 29682237 PMCID: PMC5901253 DOI: 10.1590/1980-57642018dn12-010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Frontotemporal dementias are classically described as early onset dementias with personality and behavioral changes, however, late onset forms can also be found. Considering the paucity of information about late onset behavioral variant frontotemporal dementia and its challenging diagnosis, we present a case report of an 85-year-old woman with behavioral changes and slow progression to dementia who was first diagnosed as having bipolar disorder and then Alzheimer's disease. The Daphne scale provided a structured means to improve clinical diagnosis, also supported by characteristic features on MRI and SPECT, while CSF biomarkers ruled out atypical Alzheimer's disease.
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Affiliation(s)
- Leonardo Tafarello Martins
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Ivan Abdalla Teixeira
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,MSc Student Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Jerson Laks
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,Associate Professor, Universidade do Estado do Rio de Janeiro, RJ, Brazil.,Invited Professor, Postgraduate Program in Translational Biomedicine, Universidade do Grande Rio (Biotrans - Unigranrio)
| | - Valeska Marinho
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,PhD. Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
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Pan SY, Gao SH, Lin RC, Zhou SF, Dong HG, Tang MK, Yu ZL, Ko KM. New perspectives on dietary-derived treatments and food safety-antinomy in a new era. Crit Rev Food Sci Nutr 2016; 55:1836-59. [PMID: 24915382 DOI: 10.1080/10408398.2011.654286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite the advances in science and technology and wide use of chemical drugs, dietary intervention (or food therapy) remains useful in preventing or treating many human diseases. A huge body of evidence shows that the dietary pattern or habit is also an important contributing factor to the development of chronic diseases such as hypertension, type 2 diabetes, hyperlipidemia, and cancers. In recent years, over-the-counter health foods, nutraceuticals, and plant-derived medicinal products have been gaining popularity all over the world, particularly in developed countries. Unfortunately, owing to the contamination with various harmful substances in foods and the presence of toxic food components, food-borne diseases have also become increasingly problematic. Incidents of food poisonings or tainted food have been increasing worldwide, particularly in China and other developing countries. Therefore, the government should put in a greater effort in enforcing food safety by improving the surveillance mechanism and exerting highest standards of quality control for foods.
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Affiliation(s)
- Si-Yuan Pan
- a Beijing University of Chinese Medicine , Beijing , China
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O'Connor CM, Clemson L, Brodaty H, Gitlin LN, Piguet O, Mioshi E. Enhancing caregivers' understanding of dementia and tailoring activities in frontotemporal dementia: two case studies. Disabil Rehabil 2015; 38:704-14. [PMID: 26056858 DOI: 10.3109/09638288.2015.1055375] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this study is to describe the intervention process and results of the Tailored Activities Program (TAP) in two people diagnosed with Frontotemporal Dementia (FTD). METHOD TAP is an occupational therapy (OT) community-based intervention program that prescribes personalised activities to reduce difficult behaviours of dementia. The OT works with carers over a 4-month period (assessment, activity prescription and generalisation of strategies). Study measures were collected (blind researcher) pre- and post-intervention: cognition, functional disability, behavioural symptoms and Caregiver Confidence and Vigilance. RESULTS A 51-year-old woman with behavioural-variant FTD could consistently engage in more activities post-intervention, with scores indicating improvements to behaviour, function and caregiver confidence. A 63-year-old man with semantic variant FTD engaged well in the prescribed activities, with scores reflecting reduced carer distress regarding challenging behaviours and improved caregiver vigilance. CONCLUSIONS TAP is efficacious in FTD, allowing for differences in approach for FTD subtype, where behavioural symptoms are very severe and pervasive. IMPLICATIONS FOR REHABILITATION The Tailored Activities Program is an intervention which can be tailored to account for unique behavioural and language profiles inherent across frontotemporal dementia (FTD) subtypes. Maintaining a flexible approach when applying an intervention in FTD allows for tailoring to individual case variability within FTD subtypes.
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Affiliation(s)
- Claire M O'Connor
- a Ageing, Work & Health Research Unit, Faculty of Health Sciences, University of Sydney , Sydney , Australia
| | - Lindy Clemson
- a Ageing, Work & Health Research Unit, Faculty of Health Sciences, University of Sydney , Sydney , Australia
| | - Henry Brodaty
- b School of Psychiatry, University of New South Wales , Sydney , Australia
| | - Laura N Gitlin
- c Centre for Innovative Care in Aging, Johns Hopkins University , Baltimore , MD , USA
| | - Olivier Piguet
- d Neuroscience Research Australia , Sydney , Australia .,e School of Medical Science, University of New South Wales , Sydney , Australia , and
| | - Eneida Mioshi
- f Department of Psychiatry , University of Cambridge , UK
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O'Connor CM, Clemson L, da Silva TBL, Piguet O, Hodges JR, Mioshi E. Enhancement of carer skills and patient function in the non-pharmacological management of frontotemporal dementia (FTD): A call for randomised controlled studies. Dement Neuropsychol 2013; 7:143-150. [PMID: 29213832 PMCID: PMC5619510 DOI: 10.1590/s1980-57642013dn70200002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
FTD is a unique condition which manifests with a range of behavioural symptoms,
marked dysfunction in activities of daily living (ADL) and increased levels of
carer burden as compared to carers of other dementias. No efficacious
pharmacological interventions to treat FTD currently exist, and research on
pharmacological symptom management is variable. The few studies on
non-pharmacological interventions in FTD focus on either the carer or the
patients' symptoms, and lack methodological rigour. This paper reviews and
discusses current studies utilising non-pharmacological approaches, exposing the
clear need for more rigorous methodologies to be applied in this field. Finally,
a successful randomised controlled trial helped reduce behaviours of concern in
dementia, and through implementing participation in tailored activities, the
FTD-specific Tailored Activities Program (TAP) is presented. Crucially, this
protocol has scope to target both the person with FTD and their carer. This
paper highlights that studies in this area would help to elucidate the potential
for using activities to reduce characteristic behaviours in FTD, improving
quality of life and the caregiving experience in FTD.
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Affiliation(s)
- Claire M O'Connor
- Ageing, Work & Health Research Unit, Faculty of Health Sciences, University of Sydney.,Neuroscience Research Australia, Sydney, Australia
| | - Lindy Clemson
- Ageing, Work & Health Research Unit, Faculty of Health Sciences, University of Sydney
| | - Thaís Bento Lima da Silva
- Behavioural and Cognitive Neurology Unit, Neurology Department, University of São Paulo, São Paulo SP, Brazil
| | - Olivier Piguet
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Science, University of New South Wales, Sydney, Australia
| | - John R Hodges
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Science, University of New South Wales, Sydney, Australia
| | - Eneida Mioshi
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Science, University of New South Wales, Sydney, Australia
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López-Pousa S, Calvó-Perxas L, Lejarreta S, Cullell M, Meléndez R, Hernández E, Bisbe J, Perkal H, Manzano A, Roig AM, Turró-Garriga O, Vilalta-Franch J, Garre-Olmo J. Use of antidementia drugs in frontotemporal lobar degeneration. Am J Alzheimers Dis Other Demen 2012; 27:260-6. [PMID: 22605780 PMCID: PMC10697352 DOI: 10.1177/1533317512447887] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
INTRODUCTION Clinical evidence indicates that acetylcholinesterase inhibitors (AChEIs) are not efficacious to treat frontotemporal lobar degeneration (FTLD). The British Association for Psychopharmacology recommends avoiding the use of AChEI and memantine in patients with FTLD. METHODS Cross-sectional design using 1092 cases with Alzheimer's disease (AD) and 64 cases with FTLD registered by the Registry of Dementias of Girona. Bivariate analyses were performed, and binary logistic regressions were used to detect variables associated with antidementia drugs consumption. RESULTS The AChEIs were consumed by 57.6% and 42.2% of the patients with AD and FTLD, respectively. Memantine was used by 17.2% and 10.9% of patients with AD and FTLD, respectively. Binary logistic regressions yielded no associations with antidementia drugs consumption. CONCLUSIONS There is a discrepancy regarding clinical practice and the recommendations based upon clinical evidence. The increased central nervous system drug use detected in FTLD requires multicentric studies aiming at finding the best means to treat these patients.
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Affiliation(s)
- Secundino López-Pousa
- Unitat de Recerca, Institut d’Assistència Sanitària, Salt, Spain
- Unitat de Valoració de la Memòria i les Demències, Hospital Santa Caterina de Salt, Spain
| | | | - Saioa Lejarreta
- Unitat de Valoració de la Memòria i les Demències, Hospital Santa Caterina de Salt, Spain
| | - Marta Cullell
- Servei de Neurologia, Hospital de Figueres, Figueres, Spain
| | - Rosa Meléndez
- Unitat de Malalties Neurodegeneratives i Desmielinitzants, Servei de Neurologia, Hospital Universitari Dr. Josep Trueta de Girona, Spain
| | | | - Josep Bisbe
- Servei de Neurologia, Geriatria i Medicina Interna, Hospital Comarcal Sant Jaume d’Olot, Olot, Spain
| | - Héctor Perkal
- Servei de Neurologia i Geriatria, Hospital Comarcal de Blanes, Blanes, Spain
| | - Anna Manzano
- Hospital Comarcal de Campdevànol, Campdevànol, Spain
| | | | | | - Joan Vilalta-Franch
- Unitat de Recerca, Institut d’Assistència Sanitària, Salt, Spain
- Unitat de Valoració de la Memòria i les Demències, Hospital Santa Caterina de Salt, Spain
| | - Josep Garre-Olmo
- Unitat de Recerca, Institut d’Assistència Sanitària, Salt, Spain
- Unitat de Valoració de la Memòria i les Demències, Hospital Santa Caterina de Salt, Spain
- Servei de Neurologia, Hospital de Figueres, Figueres, Spain
- Unitat de Malalties Neurodegeneratives i Desmielinitzants, Servei de Neurologia, Hospital Universitari Dr. Josep Trueta de Girona, Spain
- Unitat de Deméncies, Hospital de Palamós, Girona, Spain
- Servei de Neurologia, Geriatria i Medicina Interna, Hospital Comarcal Sant Jaume d’Olot, Olot, Spain
- Servei de Neurologia i Geriatria, Hospital Comarcal de Blanes, Blanes, Spain
- Hospital Comarcal de Campdevànol, Campdevànol, Spain
- Pharmacy Unit, Health Region of Girona, Girona, Spain
- Departament de Psicologia, Universitat de Girona, Spain
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