Project - Apathy in Dementia: Mechanisms and potential interventions

Research Project Abstract

One of the most common symptoms in dementia is apathy - a reduction in concern, motivation or interest. Apathy impacts on a person’s ability to engage in necessary daily activities (e.g., cooking, washing, visiting friends) and often leads to people being placed in aged care facilities.

This project will investigate the mechanisms which give rise to apathy in dementia. Understanding these mechanisms is the first step in developing new interventions to treat this challenging symptom. (2017-2020)

Project with a disease tag

Dementia, FTD, AD

Challenges within the field

There is a lack of tests to detect apathy in people with dementia. Most studies have relied on carer’s reports. Here we are using novel tests that are more sensitive and theoretically driven.

Key Publications from this project

• Wei. G., Irish, M., Hodges, JR., Piguet, O. & Kumfor, F. (in press) Disease-specific profiles of apathy in Alzheimer’s disease and behavioural-variant frontotemporal dementia differ across the disease course. Journal of Neurology. Accepted 14.12.19
• Wong, S., Strudwick, J., Devenney, E., Hodges, JR., Piguet, O. & Kumfor, F. (2019) Frontal variant of Alzheimer’s disease masquerading as behavioural-variant frontotemporal dementia: A case study comparison. Neurocase, 25(1-2), 48-58.
• Kumfor, F., Zhen, A., Hodges, JR., Piguet, O. & Irish, M. (accepted 20.03.18) Apathy in Alzheimer’s disease and frontotemporal dementia: Distinct clinical profiles and neural correlates. Cortex, 103, 350-359
• Wong, S., Balleine, B., & Kumfor, F. (2018) A new framework for conceptualising symptoms in frontotemporal dementia: from the lab to the clinic. Brain, 141(8), 2245-2254.
• Johnson, E. & Kumfor, F. (2018) Overcoming apathy in frontotemporal dementia: Challenges and future directions. Current Opinion in Behavioural Sciences, 22, 82-89.

Project - Social and Behavioural Disturbances in Dementia: Optimising Detection and Treatment

Research Project Abstract

Social and behavioural disturbances represent one of the major contributions of economic and social burden in dementia. These disturbances include aggression, apathy, social inappropriateness, loss of empathy and antisocial behaviour. These features are estimated to affect at least 90% of people with dementia at some point in the disease course, representing a profound challenge for untrained and ill-equipped families to manage and, thus, often lead to early institutionalisation. Yet, the mechanisms which give rise to these social and behavioural changes, how they manifest in real-world situations and how they can be treated and managed is poorly understood. My program of research aims to tackle these problems using a combination of neuropsychological, psychophysiological, neuroimaging and intervention methodologies.

Project with a disease tag

Dementia, MND, FTD, AD, PD, HD, PPA, Ageing

Research Project Description

This research program has three main streams:

1. Providing Australian data on the consequences of dementia, with a focus on social and behavioural disturbances including: criminal behaviour, financial risk-taking, neuropsychiatric symptoms, social isolation and carer burden.
2. Determining the core cognitive and neurobiological mechanisms which give rise to social and behavioural disturbances, informed by the Research Domain Criteria (RDoC) approach.
3. Evaluating the efficacy of evidenced-based interventions to improve social and behavioural disturbances in dementia.

Research Objectives

• The findings of this program of research will be essential to inform policy and direct research into areas affecting the largest number of people and with major societal impact. Furthermore, the results will provide new insights into the mechanisms driving social and behavioural disturbances in dementia. This information is pivotal to inform theoretically based interventions to improve quality of life and independence of people with dementia and their families, and alleviate burden on our health care system.

Key Publications from this project

• Ducharme, S., Dols, A., Laforce, R., Devenney, E., Kumfor, F., van den Stock, J., Dallaire-Théroux, C., Seelaar, H., Gossink, F., Vijverberg, E., Huey, E., Vandenbulcke, M., Masellis, M., Trieu, C., Onyike, C., Caramelli, P., de Souza, L.C., Santillo, A., Waldö, M.L., Landin-Romero, R., Piguet, O., Kelso, W., Eratne, D., Velakoulis, D., Ikeda, M., Perry, D., Pressman, P., Boeve, B., Vandenberghe, R., Mendez, M. Azuar, C., Levy, R., LeBer, I., Baez, S., Lerner, A., Ratnavalli, E., Pasquier, F., Galimberti, D., Scarpini, E., van Swieten, J., Hornberger, M., Rosen, H., Hodges, JR., Diehl-Schmid, J. & Pijnenburg, Y. (in press) Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders. Brain. Accepted 08.12.19
• Van den Stock, J., De Winter, F.-L., Emsell, L., Kumfor, F., & Vandenbulcke, M. (in press) Brain-behavior associations and neural representations of emotions in frontotemporal dementia. Brain. Accepted 26.11.19