Abstract. Climate change is now widely recognized as the greatest threat faced by humanity for thousands of years and is known to affect the social and environmental determinants of health; including access to clean air, safe drinking water, sufficient food, and secure shelter ( WHO, 2018 ). Anthropogenic climate change has already resulted in warming and precipitation trends that claim 150,000 lives annually, and a recent report from the WHO forecasts that between 2030 and 2050 climate change will cause an additional 250,000 additional deaths per year ( WHO, 2018 ). The interaction between climate change, mental health, and physical health is not yet well understood. This review addresses the question of how climate change is affecting mental health and will demonstrate that climate psychopathologies really matter in the face of the climate emergency.
The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was developed to assess cognitive and behavioural changes in an anterior frontotemporal syndrome (executive functions, language, fluency and behaviour), common in Amyotrophic Lateral Sclerosis (ALS) and also assesses posterior cerebral dysfunction (memory and visuospatial abilities). Objectives To validate the ECAS in behavioural variant Frontotemporal Dementia (bvFTD) without ALS, as compared with Alzheimer’s disease (AD), against comprehensive neuropsychological assessment. Compare its sensitivity to that of the Addenbrooke’s Cognitive Examination (ACE‐III) and investigate behavioural changes in both types of dementia. Methods Retrospective study of 16 people with bvFTD (without ALS), 32 with AD, and 48 healthy controls completed the ECAS, ACE‐III and extensive neuropsychological assessment. Results The ECAS showed higher sensitivity (94%) and marginally lower specificity (96%) than the ACE‐III for both the bvFTD and AD groups. The anterior composite subscore was sensitive for bvFTD (94%), and slightly less so for AD (84%), while the posterior composite subscore was sensitive for AD (97%), and less so for bvFTD (75%). All people with bvFTD that were impaired on the ECAS total and anterior composite scores were also impaired on the anterior function’s tests of the neuropsychological assessment. A cut‐off of four or more behavioural domains affected differentiated well between the bvFTD and AD groups, while a qualitative analysis of the behavioural interview found different themes between groups. Conclusions The ECAS is a valid and sensitive assessment for bvFTD without ALS and for AD. The carer behavioural interview makes it particularly suitable to detect behavioural abnormalities related to frontal lobe disorders
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