Knowledge and Attitudes for the Management of Behavioral Variant of Frontotemporal Dementia.

Sheila Castro-Suarez,Victor Osorio-Marcatinco,Maria Meza-Vega,César Caparó-Zamalloa,Erik Guevara-Silva,Mario Cornejo-Olivas,Bruce Miller

doi:10.3389/fneur.2021.786448

Abstract

Background: The diagnosis of the behavioral variant of frontotemporal dementia (bvFTD) can be especially challenging and is relatively underdiagnosed. There is scarce information on training and attitudes from care providers facing bvFTD in settings with limited resources. We aim to describe clinical knowledge and attitudes facing bvFTD from neurologists, psychiatrists, and residents in Peru.Methods: Potential participants received invitations by email to complete an online questionnaire. In addition, we reviewed 21 curricula from undergraduate medical schools' programs offered by the main schools of medicine in Peru during 2020 and 2021.Results: A total of 145 participants completed the survey. The responders were neurologists (51%), psychiatrists (25%), and residents in neurology or psychiatry (24%). Only 26% of the respondents acknowledged receiving at least one class on bvFTD in undergraduate medical training, but 66.6% received at least some training during postgraduate study. Participants identified isolated supportive symptoms for bvFTD; however, only 25% identified the possible criteria and 18% the probable bvFTD criteria. They identified MoCA in 44% and Frontal Assessment Battery (39%) as the most frequently used screening test to assess bvFTD patients. Memantine and Acetylcholinesterase inhibitors were incorrectly indicated by 40.8% of participants. Seventy six percentage of participants indicated that they did not provide education and support to the caregiver. The dementia topic was available on 95.2%, but FTD in only 19%.Conclusion: Neuropsychiatry medical specialists in Peru receive limited training in FTD. Their clinical attitudes for treating bvFTD require appropriate training focused on diagnostic criteria, assessment tools, and pharmacological and non-pharmacological management.

Highlights

Frontotemporal dementia (FTD) is considered the second most common cause of dementia between 45 and 64 years [1]
We aim to describe the clinical knowledge and attitudes facing behavioral variant frontotemporal dementia (bvFTD) from neurologists’ and psychiatrists as well as the level of undergraduate training in bvFTD in Peru
We reviewed 21 curricula from 34 different undergraduate medical schools’ programs between 2020 and 2021

Summary

Introduction

Frontotemporal dementia (FTD) is considered the second most common cause of dementia between 45 and 64 years [1]. FTD is a clinical syndrome caused by degeneration of the frontal and anterior temporal lobes and clinical manifestations include behavioral disturbances, language and executive dysfunction, and sometimes motor symptoms. The main FTD subtypes are behavioral variant frontotemporal dementia (bvFTD), nonfluent/agrammatic variant of primary progressive aphasia, and semantic variant of primary progressive aphasia [2]. Behavioral variant frontotemporal dementia is the most common clinical variant in the FTD spectrum. The diagnosis of the behavioral variant of frontotemporal dementia (bvFTD) can be especially challenging and is relatively underdiagnosed. We aim to describe clinical knowledge and attitudes facing bvFTD from neurologists, psychiatrists, and residents in Peru

Objectives

Methods

Results

Conclusion