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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.7 no.2 São Paulo Apr./June 2013

https://doi.org/10.1590/S1980-57642013DN70200002 

VIEWS & REVIEWS

Enhancement of carer skills and patient function in the non-pharmacological management of frontotemporal dementia (FTD): A call for randomised controlled studies

Reforço das habilidades dos cuidadores e da funcão do paciente no manejo não farmacológico da demência frontotemporal (DFT): necessidade para estudos clínicos randomizados e controlados

Claire M. O'Connor1  2 

Lindy Clemson1 

Thaís Bento Lima da Silva3 

Olivier Piguet2  4 

John R. Hodges2  4 

Eneida Mioshi2  4 

1Ageing, Work & Health Research Unit, Faculty of Health Sciences, University of Sydney.

2Neuroscience Research Australia, Sydney, Australia.

3Behavioural and Cognitive Neurology Unit, Neurology Department, University of São Paulo, São Paulo SP, Brazil.

4School of Medical Science, University of New South Wales, Sydney, Australia.


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.

Key words: frontotemporal dementia; non-pharmacological intervention; functional disability; randomised controlled trial

RESUMO

A DFT é uma condição única que se manifesta por uma variedade de sintomas, principalmente em atividades da vida diária (AVD) e aumento da carga sobre os cuidadores em comparação aos cuidadores de outras demências. Não existe nenhuma intervenção farmacológica para tratamento da DFT até o momento e pesquisas sobre o manejo farmacológico dos sintomas são variáveis.Os poucos estudos em intervenção não farmacológica em DFT focam nos cuidadores ou em sintomas dos pacientes, faltando rigor metodológico. Este artigo revisa e discute os estudos atuais que utilizam abordagem não farmacológica, o que expõe a clara necessidade para metodologias mais rigorosas a serem aplicadas neste campo. Finalmente, um ensaio clinico randomizado bem sucedido ajudou na redução de comportamentos em demência, através da implementação da participação em atividades ajustadas, é apresentado o FTD-specific Tailored Activities Program (TAP). Este protocolo visa abordar tanto o paciente com DFT quanto seu cuidador. Este manuscrito evidencia que pesquisas dentro desta area ajudariam a elucidar o potencial em usar estas atividades para redução dos comportamentos característicos em DFt, melhorando a qualidade de vida e experiências dos cuidadores em DFT.

Palavras-chave: demência frontotemporal; intervenção não farmacológica; ensaio clinico randomizado; incapacidade funcional

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Conflicts of interest and source of funding. EM is a recipient of a National Health Medical Research Council of Australia Early Career Fellowship (APP1016399). OP is supported by an NHMRC Clinical Career Development Fellowship (APP1022684). JRH is supported by a NHMRC Program Grant. LC is supported by an NHMRC Career Development Fellowship (APP1036639). For the remaining authors none were declared

Received: March 22, 2012; Accepted: May 23, 2013

Eneida Mioshi. Neuroscience Research Australia. PO Box 1165 - Randwick, NSW 2031 - Sydney, Australia. Email: e.mioshi@neura.edu.au

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