title: All Is Not Lost: Positive Behaviors in Alzheimer's Disease and Behavioral-Variant Frontotemporal Dementia with Disease Severity.
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Psychology, Faculty of Letters, Chuo University, Tokyo, Japan.|Neuroscience Research Australia, Sydney, Australia.
authors.forename: Akira
authors.initials: A
authors.lastname: Midorikawa
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.|Australia Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
authors.forename: Cristian E
authors.initials: CE
authors.lastname: Leyton
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|Australia Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Foxe
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|Australia Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.|School of Medical Sciences, The University of New South Wales, Sydney, Australia.
authors.forename: Ramon
authors.initials: R
authors.lastname: Landin-Romero
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|Australia Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.|School of Medical Sciences, The University of New South Wales, Sydney, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Hodges
authors.affiliation: Neuroscience Research Australia, Sydney, Australia.|Australia Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.|School of Medical Sciences, The University of New South Wales, Sydney, Australia.
authors.forename: Olivier
authors.initials: O
authors.lastname: Piguet
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D000067656:Optimism / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Alzheimer’s disease; behavioral symptoms; caregivers; factor analysis; frontotemporal dementia; progression; questionnaire development