Inappropriate trusting behaviour in dementia

Anthipa Chokesuwattanaskul; Dexter Penn; Claudia Albero; Jeremy C S Johnson; Elia Benhamou; Lucy L Russell; Chris J D Hardy; Charles R Marshall; Jonathan D Rohrer; Jason D Warren

doi:10.3389/fneur.2024.1433135

Inappropriate trusting behaviour in dementia

Front Neurol. 2024 Sep 3:15:1433135. doi: 10.3389/fneur.2024.1433135. eCollection 2024.

Authors

Affiliations

¹ Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
² Division of Neurology, Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
³ Cognitive Clinical and Computational Neuroscience Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
⁴ Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.

Abstract

Background: Inappropriate trusting behaviour may have significant social, financial and other consequences for people living with dementia. However, its clinical associations and predictors have not been clarified. Here we addressed this issue in canonical syndromes of frontotemporal dementia (FTD) and Alzheimer's disease (AD).

Methods: In 34 patients with AD and 73 with FTD (27 behavioural variant (bv)FTD, 22 semantic variant primary progressive aphasia (svPPA), 24 nonfluent/agrammatic variant (nfv)PPA) we recorded inappropriate trusting and other abnormal socio-emotional behaviours using a semi-structured caregiver survey. Patients were comprehensively characterised using a general cognitive assessment and the Revised Self-Monitoring Scale (RSMS; an informant index of socioemotional awareness).

Results: Inappropriate trusting was more frequent in svPPA (55%) and bvFTD (44%) than nfvPPA (17%) or AD (24%). After adjusting for age, sex, education and Mini-Mental State Examination (MMSE) score, inappropriate trusting was significantly more likely in svPPA (odds ratio 3.61; 95% confidence interval 1.41-8.75) and bvFTD (3.01, 1.23-6.65) than AD. Significant predictors of inappropriate trusting comprised apathy in svPPA, disinhibition and altered pain responsiveness in bvFTD, and lower MMSE and RSMS (self-presentation) scores in AD.

Conclusion: Dementia syndromes vary in prevalence and predictors of abnormal trusting behaviour, with implications for clinical counselling and safeguarding.

Keywords: Alzheimer’s disease; dementia; frontotemporal dementia; primary progressive aphasia; trust.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The Dementia Research Centre is supported by Alzheimer’s Research UK, Brain Research UK, and the Wolfson Foundation. This work was supported by the Alzheimer’s Society, Alzheimer’s Research UK and the National Institute for Health Research University College London Hospitals Biomedical Research Centre. JJ was supported by an Association of British Neurologists Clinical Research Training Fellowship. EB was supported by a Brain Research UK PhD Studentship. CH has been supported by an RNID-Dunhill Medical Trust Pauline Ashley Fellowship (PA23_Hardy). CM is supported by a grant from Bart’s Charity. JR is supported by a Medical Research Council Clinician Scientist Fellowship (MR/M008525/1), the Miriam Marks Brain Research UK Senior Fellowship and the NIHR Rare Disease Translational Research Collaboration (BRC149/NS/MH). JW receives grant support from Alzheimer’s Research UK, the Alzheimer’s Society and the National Brain Appeal (Frontotemporal Dementia Research Studentship in Memory of David Blechner). This research was funded in part by UKRI. For the purpose of Open Access, the authors have applied a Creative Commons Attribution (CC BY) public copyright licence to any author accepted manuscript version arising from this submission. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.