Exploring clinical management of cognitive and behavioural deficits in MND. A scoping review

Rebecca Francis; Stacie Attrill; Ratko Radakovic; Sebastian Doeltgen

doi:10.1016/j.pec.2023.107942

Exploring clinical management of cognitive and behavioural deficits in MND. A scoping review

Patient Educ Couns. 2023 Nov:116:107942. doi: 10.1016/j.pec.2023.107942. Epub 2023 Aug 15.

Authors

Rebecca Francis¹, Stacie Attrill², Ratko Radakovic³, Sebastian Doeltgen⁴

Affiliations

¹ Speech Pathology, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, Australia; Swallowing Neurorehabilitation Research Laboratory, Caring Futures Institute, Flinders University, Adelaide, Australia. Electronic address: rebecca.francis@flinders.edu.au.
² Speech Pathology, School of Allied Health Science and Practice, Faculty of Health and Medicine, The University of Adelaide, Adelaide, Australia.
³ Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK; Euan MacDonald Centre for Motor Neuron Disease Research, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
⁴ Speech Pathology, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, Australia; Swallowing Neurorehabilitation Research Laboratory, Caring Futures Institute, Flinders University, Adelaide, Australia.

PMID: 37597466
DOI: 10.1016/j.pec.2023.107942

Abstract

Objectives: Little is known about how cognitive and behavioural decline in MND is managed clinically. This review aimed to summarise clinical management approaches of cognitive and behavioural decline in MND reported in peer-reviewed and grey literature.

Methods: A scoping review was conducted across Embase, Medline, Psychinfo and Emcare in October 2022. Grey literature was also searched across Google Scholar and Google in October 2022.

Results: A total of N = 26 studies and 8 documents were included. Thematic analysis revealed six key areas of clinical management: i. Assessment, ii. Education, iii. Advance Care Planning, iv. Adaptation of Care Plan, v. Communication and vi. Carer Support.

Conclusions: The literature on management of cognitive and behavioural decline in MND is sparse. Most peer-reviewed literature consists of expert commentary and there is a lack of primary data to guide practitioners and families on how to manage cognitive and behavioural change in MND.

Practice implications: Determining as early as practicable the presence of cognitive and behavioural changes in pwMND will enable practitioners to make adaptations to communication, provide education and supported decision-making for forward planning. This will enable individualised care, planned in partnership with families with MND, which incorporates personal needs and wishes.

Keywords: Behaviour; Clinical Management; Cognition; Motor Neuron Disease.

Publication types

Review

MeSH terms

Advance Care Planning*
Cognition
Communication
Humans
Motor Neuron Disease* / psychology
Palliative Care