P4‐400: End‐of‐life and finitude in severe dementia: View of family and physician

Abstract

Background: Frontotemporal dementia (FTD) is a type of dementia causing degeneration in the frontal and temporal lobes. Patients with FTD often show signs or symptoms of environmental dependency. We investigated patterns of television watching in patients with FTD to discern its frequency in patients with FTD, and to possibly find evidence of its relation to other environmental dependency symptoms found in FTD.C Methods: We recruited 40 patients diagnosed with FTD and 48 Alzheimer's disease patients as controls. Patients' caregivers were given a structured interview based on a questionnaire regarding patients' television watching patterns and other behavioral symptoms. Results: More patients with FTD than AD watched more TV compared to before disease onset. Compared to AD patients, FTD patients watched more hours of TV per day, and watched more hours of TV compared to before disease onset. There were more FTD patients who exhibited 'excessive -more than 12 hours/day' TV watching. More than half of the FTD patients showed signs of environmental dependency. Patients with more signs of environmental dependency watched more hours of TV. Conclusions: Thus, frontal lobe damage may cause a release of parietal lobe driven approach behavior such as a grasp reflex or possibly magnetic apraxia or utilization behavior. Environmental dependency has previously been described in FTD but there have not been studies that systematically investigated the frequency of environmental dependency in patients with FTD. The television as an appliance usually sits in a common room of a home and is placed in an area that is easily focused upon. Because of this, in patients prone to environmental dependency the mere presence of the television could act as an external environmental cue.