Characterization of Apathy in Persons With Frontotemporal Dementia and the Impact on Family Caregivers
Characterization of Apathy in Persons With Frontotemporal Dementia and the Impact on Family Caregivers
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DOI：
10.1097/wad.0b013e3182471c54
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发表时间：
2013-01-01
影响因子：
2.1
通讯作者：
Miller, Bruce L.
中科院分区：
文献类型：
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作者：
Merrilees, Jennifer;Dowling, Glenna A.;Miller, Bruce L.
本研究对行为变异性额颞叶痴呆（bvFTD）和语义性痴呆（SD）患者及其家庭照顾者的日间活动和冷漠进行了研究。共纳入22对患者-护理者：13名患有ftd， 9名患有SD。收集了行为和运动方面的数据。患者和护理人员佩戴活动手表2周，记录活动情况。我们预测，与诊断为SD的患者相比，bvFTD患者会表现出更多的照顾者冷漠报告和更少的日间活动。bvFTD患者每天有25%的时间不活动，而SD患者每天有16%的时间不活动。BvFTD护理人员每天有11%的时间是不活动的，SD护理人员每天有9%的时间是不活动的。所有bvFTD患者和除1例SD患者外的所有SD患者均存在冷漠；bvFTD患者冷漠程度高于SD患者。在两组中，冷漠都与照顾者的情绪困扰相关。总之，冷漠被定义为一种动机减弱、难以实施的状态。在额颞叶痴呆患者中，冷漠与较低的活动水平、较多的不活动次数和较长的不活动持续时间有关。冷漠和减少白天活动似乎对照顾者有影响。对行为输出的客观测量可能有助于对冷漠做出更精确的定义。
This study characterized daytime activity and apathy in patients with behavioral variant frontotemporal dementia (bvFTD) and semantic dementia (SD) and their family caregivers. Twenty-two patient-caregiver dyads were enrolled: 13 bvFTD and 9 SD. Data were collected on behavior and movement. Patients and caregivers wore Actiwatches for 2 weeks to record activity. We predicted that bvFTD patients would show greater caregiver report of apathy and less daytime activity compared with patients diagnosed with SD. Patients with bvFTD spent 25% of their day immobile, whereas patients with SD spent 16% of their day inactive. BvFTD caregivers spent 11% of their day immobile and SD caregivers were immobile 9% of their day. Apathy was present in all of the patients with bvFTD and in all but one patient with SD; the severity of apathy was greater in bvFTD compared with SD. Apathy correlated with caregiver emotional distress in both groups. In conclusion, apathy has been defined as a condition of diminished motivation that is difficult to operationalize. Among patients with frontotemporal dementia, apathy was associated with lower levels of activity, greater number of bouts of immobility, and longer immobility bout duration. Apathy and diminished daytime activity appeared to have an impact on the caregiver. Objective measures of behavioral output may help in formulation of a more precise definition of apathy.