Behavioural and psychological symptom determinants of carer burden across clinical syndromes associated with frontotemporal lobar degeneration and Alzheimer's disease: a transdiagnostic analysis.

IF 5.4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2026-09-12 DOI:10.1007/s00415-026-14132-1

Tao Chen, Qingyu Sun, David Foxe, Manisha Narasimhan, Claris Teng, Sau Chi Cheung, James Carrick, James R Burrell, Yun Tae Hwang, Rebekah M Ahmed, Olivier Piguet, Muireann Irish

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引用次数: 0

Abstract

Background: This study characterised overall transdiagnostic associations between psychological and behavioural symptoms and carer burden, and examined syndrome-specific contributions across clinically probable FTLD and AD groups.

Methods: A total of 432 individuals with clinically probable FTLD and AD were included. The primary analytic cohort comprised 358 participants with complete carer burden data, including 230 and 128 individuals in the FTLD and AD diagnostic groups, respectively. Behavioural and psychological symptoms were assessed using the Cambridge Behavioural Inventory-Revised (CBI-R). Carer burden was measured with the Zarit Burden Interview (ZBI). Longitudinal CBI-R and ZBI data were analysed in 172 participants with available ZBI data at both baseline and follow-up (mean interval ≈ 1 year).

Results: Behavioural rigidity (standardised β = 0.15, 95% CI [0.03, 0.28], p = 0.015) and apathy (standardised β = 0.14, 95% CI [0.02, 0.26], p = 0.020) showed the strongest associations with carer burden overall. Behavioural rigidity was salient in the FTLD group (standardised β = 0.18, 95% CI [0.02, 0.33], p = 0.024), whereas apathy (standardised β = 0.26, 95% CI [0.04, 0.47], p = 0.021) and abnormal behaviour (standardised β = 0.26, 95% CI [0.05, 0.48], p = 0.018) were salient in the AD group. Longitudinal increases in mood-related symptoms (standardised β = 0.24, 95% CI [0.001, 0.48], p = 0.048) predicted greater carer burden at follow-up.

Conclusions: Our findings highlight the relevance of symptom-focussed strategies for managing carer burden across dementia syndromes. Group-specific analyses suggest prioritising behavioural rigidity in FTLD syndromes and apathy and abnormal behaviour in AD subtypes, while timely management of changes in mood symptoms may help alleviate carer burden over time.

查看原文本刊更多论文

与额颞叶变性和阿尔茨海默病相关的临床综合征中护理人员负担的行为和心理症状决定因素：一项跨诊断分析

背景：本研究描述了心理和行为症状与护理人员负担之间的总体跨诊断关联，并检查了临床可能的FTLD和AD组中综合征特异性的贡献。方法：共纳入432例临床疑似FTLD和AD患者。主要分析队列包括358名具有完整护理负担数据的参与者，分别包括FTLD和AD诊断组的230人和128人。使用剑桥行为量表（CBI-R）评估行为和心理症状。采用Zarit burden Interview （ZBI）测量照顾者负担。对172名参与者的纵向CBI-R和ZBI数据进行分析，这些参与者在基线和随访期间（平均间隔≈1年）均有可用的ZBI数据。结果：行为僵化（标准化β = 0.15, 95% CI [0.03, 0.28], p = 0.015）和冷漠（标准化β = 0.14, 95% CI [0.02, 0.26], p = 0.020）与照顾者负担的相关性最强。行为僵化在FTLD组显著（标准化β = 0.18, 95% CI [0.02, 0.33], p = 0.024），而冷漠（标准化β = 0.26, 95% CI [0.04, 0.47], p = 0.021）和异常行为（标准化β = 0.26, 95% CI [0.05, 0.48], p = 0.018）在AD组显著。情绪相关症状的纵向增加（标准化β = 0.24, 95% CI [0.001, 0.48], p = 0.048）预示随访时护理人员负担加重。结论：我们的研究结果强调了以症状为重点的策略与管理痴呆综合征护理人员负担的相关性。群体特异性分析表明，在FTLD综合征中优先考虑行为僵化，在AD亚型中优先考虑冷漠和异常行为，而及时管理情绪症状的变化可能有助于减轻护理人员的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.