All is not lost: positive behaviors in Alzheimer’s disease and behavioral-variant frontotemporal dementia with disease severity
Open accessAbstract
BACKGROUND: Anecdotal evidence indicates that some patients with dementia exhibit novel or increased positive behaviors, such as painting or singing, after the disease onset. Due to the lack of objective measures, however, the frequency and nature of these changes has not been formally investigated. OBJECTIVE: This study aimed to systematically identify changes in these behaviors in the two most common younger-onset dementia syndromes: Alzheimer's disease (AD) and behavioral-variant frontotemporal dementia (bvFTD). METHODS: Sixty-three caregivers of patients with dementia (32 caregivers of AD patients and 31 caregivers of bvFTD patients) participated in the study. Caregivers rated the presence and frequency of positive and negative behavior changes after the onset of dementia using the Hypersensory and Social/Emotional Scale (HSS) questionnaire, focusing on three domains: sensory processing, cognitive skills, and social/emotional processing. Six composites scores were obtained reflecting these three domains (two composite scores for each domain). Differences across scores and ratios of increased and decreased behaviors were analyzed between AD and bvFTD, at different disease severity levels. RESULTS: After disease onset, significant changes in the sensory processing domain were observed across disease severity levels, particularly in AD. Composite scores of the other domains did not change significantly. Importantly, however, some novel or increased positive behaviors were present in between 10% (Music activities) and 70% (Hypersensitivity) of AD and bvFTD patients, regardless of disease severity. CONCLUSIONS: We provide the first systematic investigation of positive behaviors in AD and bvFTD. The newly developed HSS questionnaire is a valid measure to characterize changes and progression of positive behaviors in patients with dementia.
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Disease progression in bvFTD has been associated with various behavioral changes, from an increase in core features to specific changes, that correlate with FTD-specific progression measures.
“Disease progression in bvFTD has been associated with various behavioral changes, from an increase in core features, e.g., decreased socio-emotional abilities and increased multi-dimensional apathy, to specific changes, e.g., increased fat preference and hypersensitivity to loud noises (Midorikawa et al., 2016; Wei et al., 2020; Ahmed et al., 2021; Foster et al., 2022), that correlate with FTD-s”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Midorikawa et al., 2016
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Fieldhouse, J. L. P., van Paassen, D. N., van Engelen, M.-P. E., De Boer, S. C. M., Hartog, W. L., Braak, S., Schoonmade, L. J., Schouws, S. N. T. M., Krudop, W. A., Oudega, M. L., et al. (2024) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2024.1382593 · Cited by 8 · see citing works
- Authors
- Midorikawa, A., Leyton, C. E., Foxe, D., Landin-Romero, R., Hodges, J. R., & Piguet, O.
- Affiliations
- Neuroscience Research Australia (AU)
- The University of Sydney (AU)
- ARC Centre of Excellence in Cognition and its Disorders (AU)
- Neuroscience Research Australia, Sydney, Australia
- UNSW Sydney (AU)
- Corresponding author
- Midorikawa, Akira
- Piguet, Olivier
- Venue
- Journal of Alzheimer's Disease
- Publisher
- SAGE Publications
- Published
- 2016-09-06
- Volume
- 54
- Issue
- 2
- Pages
- 549-558
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- PMC
- PMC5026134
- OpenAlex
- W2476728002
- Cited by
- 20
- References
- 40
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 2
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Alzheimer s Disease (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Chuo University
- Medical Research Council
- National Health and Medical Research Council (1037746)
- Japan Society for the Promotion of Science (15K04191, 16H01517)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- Alzheimer's disease, behavioral variant frontotemporal dementia
- MeSH terms
- Optimism, Aged, Alzheimer Disease, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Surveys and Questionnaires, Severity of Illness Index, Caregivers, Frontotemporal Dementia
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