Frontotemporal dementia: behavioral symptoms and caregiver distress.
OBJECTIVE
To discern behavioral problems that co-occur in frontotemporal dementia (FTD) patients, and to investigate the relation between behavioral clusters and the burden for caregivers.


METHODS
Baseline data of 63 FTD patients and their respective caregivers were used to detect the behavioral clusters in the Neuropsychiatric Inventory (NPI) and the accompanying distress evoked in caregivers. To detect the clusters in behavior of the FTD patients, we performed multidimensional scaling (procedure: PROXSCAL). Multiple regression analysis was used to determine the association between behavior of patients and the distress experienced by caregivers.


RESULTS
This was the first study that found behavioral clusters for FTD. Two behavioral clusters were found: agitation/psychosis (comprising delusions, hallucinations, irritability and agitation) and mood (made up of anxiety and depression). The remaining NPI domains (euphoria, disinhibition, aberrant motor behavior and apathy were found to be autonomous. After controlling for relevant confounding factors, caregiver distress was strongest related to agitation/psychosis, followed by mood. Disinhibition and aberrant motor behavior were mildly related to caregiver distress. Euphoria and apathy were not significantly related to distress. Caregivers of patients living at home were more distressed by the behavioral problems of the FTD patients than caregivers of hospitalized patients.


CONCLUSIONS
The high prevalence of psychopathology in FTD patients and the associated caregiver distress was confirmed in this study. Clustering behavioral symptoms allows investigation of the relationship between structural or functional cerebral deficits and neuropsychiatric symptoms.
Department of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands. j.mourik@erasmusmc.nl
J C
JC
Mourik
S M
SM
Rosso
M F
MF
Niermeijer
H J
HJ
Duivenvoorden
J C
JC
Van Swieten
A
A
Tibben
D000328:Adult; D000368:Aged; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000209:etiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013702:Temporal Lobe / Q000503:physiopathology*