P4‐154: The tailored activities program (TAP) for the management of frontotemporal dementia: A case study
Bibliographic record
Abstract
Frontotemporal dementia (FTD) is a unique condition which manifests with a range of behavioural symptoms, dysfunction in activities of daily living and greater caregiver distress when compared to caregivers of other dementias such as Alzheimer's disease. With research into pharmacological treatments yet to show any clear benefit in FTD, research into non-pharmacological management is crucial, especially in light of marked impairments in activities of daily living (ADLs) and severe behavioural changes. Describe a person with FTD receiving TAP. TAP is a community-based occupational therapy (OT) intervention prescribing personalised activities for persons with dementia. Visits which are conducted in-home over a 4-month period are structured around three phases: assessment, activity prescription, and generalisation of strategies. Throughout the intervention there is a close collaborative relationship between the OT and caregivers, with an educational focus on dementia and skills in activity simplification, communication, and environmental modification. For the case study, measures included: Global cognition (Montreal Cognitive Assessment), functional disability (Disability Assessment for Dementia), Behavioural changes (Neuropsychiatric Inventory – Clinician rating scale), caregiver confidence, and Vigilance items, which occurred at baseline and 4 months (post-intervention). A 66-year-old man (Randall*, bvFTD) participated in TAP. After intervention, Randall's cognitive score on the MoCA remained constant. Randall improved his basic ADL score (+6%), retained a constant level of instrumental ADL functioning and improved his overall ADL score on the DAD (+2%). Caregiver confidence reduced (-0.5%; of note, baseline score was at ceiling). While vigilance feelings of “being on duty” worsened (+5.5), there was no change to time the caregiver was “actually doing things” for Randall. Caregiver distress regarding behaviours increased for dysphoria (+1), apathy (+2) and appetite and eating disorders (+3); however decreased for agitation (-7) and anxiety (-5). FTD is a unique condition with its core behavioural features often resulting in higher levels of caregiver distress than other dementias. At an individual level, this case highlighted the great benefit of TAP at improving function and reducing marked behavioural changes. An ongoing randomised controlled trial in Australia will reveal the benefits of TAP at a group level. *Name changed to preserve confidentiality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".