ECOCAPTURE@CARE

Being almost universally present during the course of dementia, the Behavioral and psychological symptoms of dementia (BPSD) include apathy, agitation, aberrant motor behavior, anxiety, irritability, depression, disinhibition, delusions, hallucinations, and sleep or appetite changes (Cerejeira et al., 2012). BPSD are very common and associated with high levels of distress both in patients and their caregivers, as well as with adverse outcomes (e.g. cognitive deterioration). Symptoms of cognitive impairment and BPSD may be treated with a variety of non-pharmacological interventions (NPIs) that span psychological, behavioral and environmental domains. To date, a number of systematic and literature reviews have identified evidence-based nonpharmacological practices to address cognitive impairment and BPSD (Scales et al., 2018). However, It is still not known what mechanisms are being targeted, but this is necessary to tailor these interventions accordingly and individually to increase the effectiveness of these treatments (Charras et al., 2020).

Apathy is the most common BPSD and is associated with a range of adverse outcomes including cognitive decline. As a common characteristic symptom, apathy is often targeted with the interventions. In 2012, Cai. et al. reviewed the effectiveness of NPI on apathy in patients with dementia, and identified that multisensory stimulation, receptive music therapy, cognitive stimulation, and pet therapy can improve apathy in patients with dementia. However, apathy is a broad multifactorial concept, which may therefore act along multiple mechanistic pathways, interacting with individual and disease-specific aspects. The scope of this study is the apathetic behavior in neurodegenerative diseases (AD, bvFTD) and its neural and physiological mechanisms.

The main objective of the study EOCAPTURE@CARE is to target apathy with NPI in dementia. The behavior exhibited is not just about the brain, it also depends upon a complex and changing environment and social interactions which a person is subjected to. The manifested behavior is the result of: 1/ the environment, including social interactions (particularly dyads between patient and partner/caregiver), that will facilitate the triggering of a particular behavior, and 2/ the state of the physiological brain mechanisms. In order to tailor a holistic personalized treatment approach, the study ECOCAPTURE@CARE focuses not only on apathy but also on other disease-related BPSD like anxiety, depression, stress, and sleep disturbances as well as on the environment and the caregiver/partner-patient dyadic interaction (quality of life, resilience, stress, burden).

Consequently, the study ECOCAPTURE@CARE will be patient-centered and set according to the brain pathology, as well as according to the caregiver/partner-patient dyadic interaction.

References

1. Cai Y, Li L, Xu C, Wang Z. The Effectiveness of Non-Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews. Worldviews Evid Based Nurs. 2020 Aug;17(4):311-318. https://doi.org/10.1111/wvn.12459.

2. Charras K, Dramé M. Treatment Indications in Clinical Practice and Applied Research on Psychosocial Interventions for People With Dementia. Am J Alzheimers Dis Other Demen. 2020.

3. Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Frontiers in Neurology.

4. Kezia Scales, Sheryl Zimmerman, Stephanie J Miller, MSW. (2018). Evidence-Based Nonpharmacological Practices to Address Behavioral and Psychological Symptoms of Dementia, The Gerontologist, Volume 58, Issue suppl_1, February 2018, Pages S88–S102.