Diagnostic, management and nursing challenges of less common dementias: Frontotemporal dementia, alcohol-related dementia, HIV dementia and prion diseases

Abstract

Background: Most cases of dementia are due to Alzheimer's disease or vascular dementia, but attention on these disorders means that other important causes of dementia may be relatively neglected. About 10?15% of people with dementia have other diagnoses, and there are numerous causes of the less common types of dementia. Aims: This paper provides information about the causes, symptoms, diagnosis and nursing management of some of the different types of less common dementias, with the aim of helping nurses to provide better care to patients and families affected. Methods: This is one of two connected papers and provides a narrative review of the literature on the clinical presentation of frontotemporal dementia, HIV dementia, prion dementias and alcohol-related dementia. Findings: Frontotemporal dementia has important clinical subtypes with distinct different presentations; for example, predominantly behavioural symptoms or progressive language dysfunction. Alcohol-related dementia is one of several types of alcohol-related brain damage. This is important as, with abstinence, its progression may be halted or even to some extent improved. HIV dementia has become less common since the introduction of effective antiretroviral therapy, but, nonetheless, the less severe picture of HIV-associated cognitive dysfunction remains prevalent despite treatment. Prion dementias encompass sporadic, familial and acquired Creutzfeldt-Jakob disease and are incurable, therefore requiring extensive palliative care. Conclusions: These forms of dementia all have different symptoms and courses from common types of dementia, such as Alzheimer's disease. It is important for nurses to be aware that dementia may have several causes and that people with different dementias will have different needs. Nonetheless, the general skills of nurses in supporting patients and families remain essential in order to develop appropriate care plans and to provide individualised, person-centred care.