Exploring profiles of social behaviour in dementia syndromes: Identifying targets for intervention

Abstract

The behavioural variant of frontotemporal dementia (bvFTD) is characterised by social impairments that impact social behaviour. This thesis examines how apathy and disinhibition, core features of bvFTD, manifest as behaviour within the social environment, and discusses the implications of these symptoms on the capacity for social behaviour. Chapter 1 describes the background of bvFTD and associated disorders, and the social symptoms of bvFTD. This is followed by a short review of apathy in bvFTD in Chapter 2. Chapter 3 examines the utility of a novel task to assess social disinhibition in bvFTD. Results demonstrated that while people with bvFTD display increased social disinhibition, the provision of guidelines about social expectation facilitate more appropriate social behaviour. Chapter 4 explores whether aspects of prosocial motivation are retained in bvFTD to modify behaviour in social settings to foster their own social reputation. The results indicate that people with bvFTD appear to adjust behaviour when they are conscious that their social choices are being observed. This may indicate that prosocial motivation to engage in reputation management is retained in people with bvFTD, to some extent. The findings have implications for developing interventions to facilitate prosocial behaviour in patients. In Chapter 5, the thesis turns to examine the role of oxytocin in dementia syndromes. The findings of this study indicate that plasma oxytocin levels are not reduced in dementia, which has implications for the measurement of oxytocin in future clinical trials. Collectively, the results of this thesis reveal the importance of considering behavioural symptoms as they are manifested in social context. From a clinical perspective, these findings have important implications for the management of social impairment in bvFTD.