Non-Pharmacological Management for Patients with Frontotemporal Dementia: A Systematic Review

Article type: Research Article

Authors: Shinagawa, Shunichiro^{a; b; *} | Nakajima, Shinichiro^{c; d; e; f} | Plitman, Eric^{e; g} | Graff-Guerrero, Ariel^{d; e; f} | Mimura, Masaru^c | Nakayama, Kazuhiko^a | Miller, Bruce L.^b

Affiliations: [a] Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan | [b] Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA | [c] Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan | [d] Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, ON, Canada | [e] Multimodal Imaging Group – Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada | [f] Department of Psychiatry, University of Toronto, Toronto, ON, Canada | [g] Institute of Medical Science, University of Toronto, Toronto, ON, Canada

Correspondence: [*] Correspondence to: Shunichiro Shinagawa, MD, PhD, Department of Psychiatry, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. Tel.: +81 3 3433 1111; Fax: +81 3 3437 0228; E-mail: shinagawa@jikei.ac.jp.

Abstract: Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by changes in behavior and language caused by focal degeneration of the frontal and anterior temporal lobes. The behavioral symptoms are distressing to patients and their caregivers. Non-pharmacological management is important as no disease-specific pharmacological treatment for FTD is currently available. The primary objective is to review the literature on non-pharmacological management for FTD and to propose directions for future research, with reference to findings. A search was performed using PubMed, MEDLINE, and EMBASE. Search terms included “frontotemporal dementia”, and words related to non-pharmacological management, and it identified a total of 858 articles. Results revealed that very few randomized controlled trials exist on non-pharmacological management interventions for FTD. These interventions have been proposed by literature based on clinical experience. A small number of studies have supported behavioral management techniques that exploit disease-specific behaviors and preserved functions in patients with FTD, along with the management of caregivers' distress. These limitations warrant well-designed large-scale research to examine effects of non-pharmacological interventions on behavioral symptoms of FTD.

Keywords: Behavioral management, caregiver support, environmental strategies, non-pharmacological interventions in frontotemporal dementia

DOI: 10.3233/JAD-142109

Journal: Journal of Alzheimer's Disease, vol. 45, no. 1, pp. 283-293, 2015