Awareness and cognitive rehabilitation in Alzheimer's disease and frontotemporal dementia

IF 4.9 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2024-04-16 DOI:10.1002/trc2.12469

Eric Salmon, Françoise Lekeu, Anne Quittre, Vinciane Godichard, Catherine Olivier, Vinciane Wojtasik, Christine Bastin

{"title":"Awareness and cognitive rehabilitation in Alzheimer's disease and frontotemporal dementia","authors":"Eric Salmon, Françoise Lekeu, Anne Quittre, Vinciane Godichard, Catherine Olivier, Vinciane Wojtasik, Christine Bastin","doi":"10.1002/trc2.12469","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> INTRODUCTION</h3>\n \n <p>Awareness influences the evolution of neurodegenerative dementias. We gathered participants’ and caregivers assessments of dependence in daily activities and we studied how each score would be related to next year participant autonomy, independently of other explicative variables.</p>\n </section>\n \n <section>\n \n <h3> METHOD</h3>\n \n <p>We retrospectively analyzed data from mildly demented participants with a clinical diagnosis of Alzheimer's disease (AD, <i>n</i> = 186) and frontotemporal dementia (FTD, <i>n</i> = 29) and their relatives. A research tool was used to assess participant dependence in 98 daily activities and associated caregiver burden. A discrepancy score between the patient's and relative's judgment was calculated to evaluate awareness of dependence in activities at baseline. This dependence scores, as well as sex, age, education, and 1 year difference in Mini-Mental State Examination were taken as possible explicative variables for dependence in activities adapted by therapists during a 1-year cognitive rehabilitation program.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>Patients with FTD showed less awareness for daily dependence (discrepancy 20.9% vs. 11.8% in AD). Both groups benefited from cognitive rehabilitation (25% decrease in dependence) and subjective burden of relatives was decreased in both groups. In the AD group, there was a significant positive relationship between both caregiver (<i>P</i> < 0.001) and participant's (<i>P</i> < 0.02) evaluation of dependence in daily activities at inclusion and dependence of participants in adapted activities after 1 year.</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>Awareness of impairment in daily activities is a clinical symptom that is more important at inclusion in FTD than in AD. However, in participants with AD who, as a group, significantly benefit from a cognitive rehabilitation program, not only caregiver's but also participant's assessment of dependence at baseline is correlated to subsequent, next year greater dependence in daily activities adapted by the therapists. Although discrepant, both caregiver and participant evaluations appear to be important variables to understand the evolution and the benefit of care in participants at early stages of dementia.</p>\n </section>\n </div>","PeriodicalId":53225,"journal":{"name":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","volume":"10 2","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.12469","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/trc2.12469","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

INTRODUCTION

Awareness influences the evolution of neurodegenerative dementias. We gathered participants’ and caregivers assessments of dependence in daily activities and we studied how each score would be related to next year participant autonomy, independently of other explicative variables.

METHOD

We retrospectively analyzed data from mildly demented participants with a clinical diagnosis of Alzheimer's disease (AD, n = 186) and frontotemporal dementia (FTD, n = 29) and their relatives. A research tool was used to assess participant dependence in 98 daily activities and associated caregiver burden. A discrepancy score between the patient's and relative's judgment was calculated to evaluate awareness of dependence in activities at baseline. This dependence scores, as well as sex, age, education, and 1 year difference in Mini-Mental State Examination were taken as possible explicative variables for dependence in activities adapted by therapists during a 1-year cognitive rehabilitation program.

RESULTS

Patients with FTD showed less awareness for daily dependence (discrepancy 20.9% vs. 11.8% in AD). Both groups benefited from cognitive rehabilitation (25% decrease in dependence) and subjective burden of relatives was decreased in both groups. In the AD group, there was a significant positive relationship between both caregiver (P < 0.001) and participant's (P < 0.02) evaluation of dependence in daily activities at inclusion and dependence of participants in adapted activities after 1 year.

DISCUSSION

Awareness of impairment in daily activities is a clinical symptom that is more important at inclusion in FTD than in AD. However, in participants with AD who, as a group, significantly benefit from a cognitive rehabilitation program, not only caregiver's but also participant's assessment of dependence at baseline is correlated to subsequent, next year greater dependence in daily activities adapted by the therapists. Although discrepant, both caregiver and participant evaluations appear to be important variables to understand the evolution and the benefit of care in participants at early stages of dementia.

Abstract Image

查看原文本刊更多论文

阿尔茨海默氏症和额颞叶痴呆症的认知和认知康复

引言意识会影响神经退行性痴呆症的演变。我们收集了参与者和护理者对日常活动依赖性的评估，并研究了每项评分与下一年参与者自主性的关系，而不考虑其他说明性变量。方法我们对临床诊断为阿尔茨海默病（AD，186 人）和额颞叶痴呆（FTD，29 人）的轻度痴呆患者及其亲属的数据进行了回顾性分析。研究工具用于评估参与者在 98 项日常活动中的依赖性以及相关的护理负担。计算患者和亲属判断之间的差异分值，以评估基线时对活动依赖性的认识。在为期 1 年的认知康复计划中，该依赖性评分以及性别、年龄、教育程度和迷你精神状态检查的 1 年差异被作为治疗师调整活动依赖性的可能解释变量。结果 FTD 患者的日常依赖意识较弱（差异为 20.9%，而 AD 患者为 11.8%）。两组患者均从认知康复中获益（依赖性降低 25%），两组患者亲属的主观负担均有所减轻。在注意力缺失症组中，护理人员（P <0.001）和参与者（P <0.02）对入组时日常活动依赖性的评价与参与者一年后适应活动的依赖性之间存在显著的正相关关系。讨论意识到日常活动障碍是一种临床症状，在纳入 FTD 时比纳入 AD 时更为重要。然而，在作为一个群体从认知康复计划中明显受益的注意力缺失症患者中，不仅是照顾者，而且参与者在基线时对依赖性的评估都与随后、即第二年在治疗师调整的日常活动中更大的依赖性相关。尽管存在差异，但护理人员和参与者的评估似乎都是了解痴呆症早期参与者护理演变和护理益处的重要变量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.