Chokesuwattanaskul Anthipa, Penn Dexter, Albero Claudia, Johnson Jeremy C S, Benhamou Elia, Russell Lucy L, Hardy Chris J D, Marshall Charles R, Rohrer Jonathan D, Warren Jason D
Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
Division of Neurology, Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Front Neurol. 2024 Sep 3;15:1433135. doi: 10.3389/fneur.2024.1433135. eCollection 2024.
Inappropriate trusting behaviour may have significant social, financial and other consequences for people living with dementia. However, its clinical associations and predictors have not been clarified. Here we addressed this issue in canonical syndromes of frontotemporal dementia (FTD) and Alzheimer's disease (AD).
In 34 patients with AD and 73 with FTD (27 behavioural variant (bv)FTD, 22 semantic variant primary progressive aphasia (svPPA), 24 nonfluent/agrammatic variant (nfv)PPA) we recorded inappropriate trusting and other abnormal socio-emotional behaviours using a semi-structured caregiver survey. Patients were comprehensively characterised using a general cognitive assessment and the Revised Self-Monitoring Scale (RSMS; an informant index of socioemotional awareness).
Inappropriate trusting was more frequent in svPPA (55%) and bvFTD (44%) than nfvPPA (17%) or AD (24%). After adjusting for age, sex, education and Mini-Mental State Examination (MMSE) score, inappropriate trusting was significantly more likely in svPPA (odds ratio 3.61; 95% confidence interval 1.41-8.75) and bvFTD (3.01, 1.23-6.65) than AD. Significant predictors of inappropriate trusting comprised apathy in svPPA, disinhibition and altered pain responsiveness in bvFTD, and lower MMSE and RSMS (self-presentation) scores in AD.
Dementia syndromes vary in prevalence and predictors of abnormal trusting behaviour, with implications for clinical counselling and safeguarding.
不适当的信任行为可能会给痴呆症患者带来重大的社会、经济和其他后果。然而，其临床关联和预测因素尚未明确。在此，我们在额颞叶痴呆（FTD）和阿尔茨海默病（AD）的典型综合征中探讨了这一问题。
我们对34例AD患者和73例FTD患者（27例行为变异型（bv）FTD、22例语义变异型原发性进行性失语（svPPA）、24例非流利/语法缺失变异型（nfv）PPA）进行研究，通过半结构化的照料者调查问卷记录不适当的信任及其他异常的社会情感行为。使用一般认知评估和修订后的自我监控量表（RSMS；社会情感意识的知情者指标）对患者进行全面特征描述。
svPPA（55%）和bvFTD（44%）中不适当信任的发生率高于nfvPPA（17%）或AD（24%）。在调整年龄、性别、教育程度和简易精神状态检查表（MMSE）评分后，svPPA（优势比3.61；95%置信区间1.41 - 8.75）和bvFTD（3.01，1.23 - 6.65）中出现不适当信任的可能性显著高于AD。不适当信任的显著预测因素包括svPPA中的冷漠、bvFTD中的脱抑制和疼痛反应改变，以及AD中较低的MMSE和RSMS（自我表现）评分。
痴呆综合征在异常信任行为的患病率和预测因素方面存在差异，这对临床咨询和保障措施具有重要意义。
