Neuropsychiatric symptoms in dementia-frequency, relationship to dementia severity and comparison in Alzheimer's disease, vascular dementia and frontotemporal dementia

2005 ◽  
Vol 236 (1-2) ◽  
pp. 43-48 ◽  
Author(s):  
S. Srikanth ◽  
A.V. Nagaraja ◽  
E. Ratnavalli
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Frontotemporal Dementia ◽  
Neuropsychiatric Symptoms ◽  
Dementia Severity ◽  
Frequency Relationship

scholarly journals Distinct network topology in Alzheimer’s disease and behavioral variant frontotemporal dementia

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Adeline Su Lyn Ng ◽  
Juan Wang ◽  
Kwun Kei Ng ◽  
Joanna Su Xian Chong ◽  
Xing Qian ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Network Topology ◽  
Neuropsychiatric Symptoms ◽  
Brain Network ◽  
Salience Network ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Control Networks ◽  
And Control

Abstract Background Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD) cause distinct atrophy and functional disruptions within two major intrinsic brain networks, namely the default network and the salience network, respectively. It remains unclear if inter-network relationships and whole-brain network topology are also altered and underpin cognitive and social–emotional functional deficits. Methods In total, 111 participants (50 AD, 14 bvFTD, and 47 age- and gender-matched healthy controls) underwent resting-state functional magnetic resonance imaging (fMRI) and neuropsychological assessments. Functional connectivity was derived among 144 brain regions of interest. Graph theoretical analysis was applied to characterize network integration, segregation, and module distinctiveness (degree centrality, nodal efficiency, within-module degree, and participation coefficient) in AD, bvFTD, and healthy participants. Group differences in graph theoretical measures and empirically derived network community structures, as well as the associations between these indices and cognitive performance and neuropsychiatric symptoms, were subject to general linear models, with age, gender, education, motion, and scanner type controlled. Results Our results suggested that AD had lower integration in the default and control networks, while bvFTD exhibited disrupted integration in the salience network. Interestingly, AD and bvFTD had the highest and lowest degree of integration in the thalamus, respectively. Such divergence in topological aberration was recapitulated in network segregation and module distinctiveness loss, with AD showing poorer modular structure between the default and control networks, and bvFTD having more fragmented modules in the salience network and subcortical regions. Importantly, aberrations in network topology were related to worse attention deficits and greater severity in neuropsychiatric symptoms across syndromes. Conclusions Our findings underscore the reciprocal relationships between the default, control, and salience networks that may account for the cognitive decline and neuropsychiatric symptoms in dementia.

Caregiver burden in atypical dementias: comparing frontotemporal dementia, Creutzfeldt–Jakob disease, and Alzheimer's disease

2015 ◽  
Vol 28 (2) ◽  
pp. 269-273 ◽  
Author(s):  
Alice Uflacker ◽  
Mary C. Edmondson ◽  
Chiadi U. Onyike ◽  
Brian S. Appleby
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Caregiver Burden ◽  
Neuropsychiatric Symptoms ◽  
Published Data ◽  
Caregiver Distress ◽  
Severity Scores ◽  
Symptom Domains ◽  
Jakob Disease

ABSTRACTBackground:Caregiver burden is a significant issue in the treatment of dementia and a known contributor to institutionalization of patients with dementia. Published data have documented increased caregiver burden in behavioral variant frontotemporal dementia (bvFTD) compared to Alzheimer's disease (AD). Another atypical dementia with high-perceived caregiver burden is sporadic Creutzfeldt–Jakob disease (sCJD), but no formal studies have assessed this perception. The aim of this study was to compare caregiver burden across atypical dementia etiologies.Methods:76 adults with atypical dementia (young-onset AD [YOAD], bvFTD, language variant FTD [lvFTD], and sCJD) were administered an abbreviated version of the Zarit Burden Interview (ZBI), Neuropsychiatric Inventory (NPI-Q), and other assessment instruments during a five-year time period at Johns Hopkins Hospital (JHH). A Cox regression model examined differences between disease categories that impact mean ZBI scores.Results:Mean ZBI scores were significantly different between dementia etiologies, with bvFTD and sCJD having the highest caregiver burden (p = 0.026). Mean NPI-Q caregiver distress scores were highest in bvFTD and sCJD (p = 0.002), with sCJD and bvFTD also having the highest number of endorsed symptom domains (p = 0.012). On regression analyses, an interactive variable combining final diagnosis category and NPI-Q total severity score demonstrated statistically significant differences in mean ZBI scores for sCJD and bvFTD.Conclusions:This study demonstrates that bvFTD and sCJD have increased levels of caregiver burden, NPI-Q caregiver distress, total severity scores, and number of endorsed symptom domains. These results suggest that higher caregiver burden in bvFTD and sCJD are disease specific and possibly related to neuropsychiatric symptoms.

scholarly journals Demência fronto-temporal em paciente feminina de 56 anos: relato de caso

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
Gabriel Pina Paiva ◽  
Fábio Henrique Ribeiro Maldonado ◽  
Amanda Oliva Spaziani
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Work Group ◽  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Dementia Patient ◽  
Evaluation Instrument ◽  
Mutual Help ◽  
Diagnosis Of Dementia

A demência é uma das mais importantes causas de morbimortalidade entre os idosos e se caracteriza pelo declínio progressivo em múltiplos domínios cognitivos. Paciente do sexo feminino, 56 anos, iniciou quadro há 3 anos, caracterizado por apatia, anedonia e isolamento social. Procurou atendimento com médico que atribuiu sintomas a depressão. Contudo, não houve melhora. Há dois anos evoluiu com delírios persecutórios, confabulações, alucinação visual. Acompanhante notou que a paciente tinha dificuldades em se expressar e na compreensão. Devido à refratariedade ao tratamento foi solicitada avaliação de neurologista.  À consulta inicial, paciente apresentava-se orientada no tempo, espaço. Mini exame do estado mental 26/30 pontos. Fluência verbal semântica. Após 6 meses, evoluiu com empobrecimento do vocabulário. À época estava dependente de familiares para realização de atividades de vida diária. Na ressonância magnética encefálica apresentou atrofia cortical difusa, com predomínio em regiões frontais e temporais à esquerda. Atualmente está em uso de risperidona e memantina. A atrofia cerebral dos lobos frontais e temporais ou demência fronto temporal (DFT) afeta predominantemente o lobo frontal do cérebro, podendo se estender para o temporal. A patologia caracteriza-se por significativa alteração da personalidade e do comportamento, com relativa preservação das funções mnésticas e visuoespaciais. A linguagem é progressivamente afetada. A memória encontra-se preservada no início da doença e as alterações comportamentais e da personalidade são bastante significativas. A variante comportamental é a mais comum. Ela apresenta uma deterioração gradual da função executiva e da personalidade, enquanto a capacidade visuoespacial é afetada apenas em estádios avançados.Descritores: Transtornos Neurocognitivos; Demência Frontotemporal; Testes de Estado Mental e Demência.ReferênciasCarrabba LHG, Menta C, Fasolin EM, Loureiro F, Gomes I. Características psicométricas das versões completa e reduzida do IQCODE-BR em idosos de baixa renda e escolaridade. Rev bras geriatr gerontol. 2015;18(4):715-23.Lopes MCBT, Lage JSS, Vancini-Campanharo CR, Okuno MFP, Batista REA. Factors associated with functional impairment of elderly patients in the emergency departments. Einstein. 2015;13(2):209-14.Trindade APNT, Barboza MA, Oliveira FB, Borges APO. Repercussão do declínio cognitivo na capacidade funcional em idosos institucionalizados e não institucionalizados. Fisioter mov. 2013;26(2):281-89.Santos JI, Rodrigues Junior C, Zogheib JB, Malachias MVB, Rezende BA.  Assessment of hemodynamic and vascular parameters in Alzheimer's disease, vascular dementia and mild cognitive abnormalities: a pilot study. Rev bras geriatr gerontol. 2017;20(5):670-78.Burlá C, Camarano AA, Kanso S, Fernandes D, Nunes R. Panorama prospectivo das demências no Brasil: um enfoque demográfico. Ciênc saúde coletiva. 2013;18(10):2949-56.Costa GD, Souza RA, Yamashita CH, Pinheiro JCF, Alvarenga MRM, Oliveira MAC. Evaluation of professional knowledge and attitudes on dementia patient care: a trans-cultural adaptation of an evaluation instrument. Rev esc enferm USP. 2015;49(2):298-308.Bosch B, Isidro R, Zayas Ll, Hernández T, Ulloa E. Algunos determinantes sociales y su impacto en las demencias. Rev Cubana Salud Pública. 2017;43(3):449-60.Josviak ND, Batistela MS, Simão-Silva DP, Bono GF, Furtado-Alle L, Souza RLR. Revisão dos principais genes e proteínas associadas à demência frontotemporal tau-positiva. Rev bras geriatr gerontol. 2015;18(1):201-11.McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7(3):263-69.Pires FRO, Santos SMA, Mello ALSF, Silva KM. Mutual Help Group for Family Members of Older Adults with Dementia: Unveiling perspectives. Texto contexto - enferm.. 2017;26(2):e00310016.Storti LB, Quintino DT, Silva NM, Kusumota L, Marques S. Neuropsychiatric symptoms of the elderly with Alzheimer's disease and the family caregivers' distress. Rev Latino-Am Enfermagem. 2016;24:e2751.Teixeira-Jr AL, Salgado JV. Demência fronto-temporal: aspectos clínicos e terapêuticos. Rev psiquiatr Rio Gd Sul. 2006;28(1):69-76.Mendes RAB. Demência Frontotemporal. Evolução do conceito e desafios diagnósticos [dissertação]. Covilhã: Faculdade de Medicina,Universidade da Beira Interior (UBI); 2015.Moreira S, Duarte S, Moreira I, Santos E. et al. Variante comportamental da demência frontotemporal: relato de caso. Rev Port Med Geral Fam. 2017;33(2):155-61.McKhann GM, Albert MS, Grossman M, Miller B, Dickson D, Trojanowski JQ et al. Clinical and pathological diagnosis of frontotemporal dementia: Report of the work group on frontotemporal dementia and pick's disease. Arch Neurol. 2001;58(11):1803-9.Rivas Nieto JC. Frontotemporal dementia: clinical, neuropsychological, and neuroimaging description. Colomb. Med (Cali). 2014;45(3):122-26.Fernádez-Matarrubia M, Matías-Guiu JA, Moreno-Ramos T,  Matías-Guiu J. Demencia frontotemporal variante conductual: aproximación clínica y terapéutica. Neurología. 2014;29(8):464-72.Lanata SC, Miller BL. The behavioural variant frontotemporal dementia (bvFTD) syndrome in psychiatry. J Neurol Neurosurg Psychiatry. 2016;87(5):501-11.

scholarly journals Neuropsychiatric symptoms and executive function impairments in Alzheimer’s disease and vascular dementia: The role of subcortical circuits

2019 ◽  
Vol 13 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Chan Tiel ◽  
Felipe Kenji Sudo ◽  
Ana Beatriz Calmon
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Executive Function ◽  
Vascular Dementia ◽  
Neuropsychiatric Symptoms ◽  
Vascular Lesions ◽  
Cognitive Test ◽  
Pathophysiological Mechanism ◽  
Clinical Dementia Rating

ABSTRACT Neuropsychiatric symptoms (NPS) in dementia are prevalent, under-recognized and little studied regarding their pathophysiological aspects. The pathophysiological mechanism, as well as the possible role of vascular lesions in the genesis of these symptoms, are still matters of debate. Objective: to describe and compare the prevalence and severity of NPS in subjects with Alzheimer's disease (AD) and vascular dementia (VaD). Methods: a cross-sectional study involving 82 outpatients, divided into two groups (AD × VaD), was conducted. Patients were submitted to the Cambridge Cognitive Test (CAMCOG), the Clock Drawing Test (CLOX 1 and 2), the Neuropsychiatric Inventory (NPI) and the Clinical Dementia Rating (CDR) scale. Neuroimaging was scored using the de Leon and Fazekas scales. Results: 90.8% of the patients had at least one neuropsychiatric symptom. There were statistical differences on the CLOX test and in the apathy symptoms between AD and VaD groups. Apathy and disinhibition proved more prevalent in patients with higher vascular load. Conclusion: apathy and impaired executive function may reflect vascular damage in subcortical circuits in dementia patients.

scholarly journals Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease: A 12-Month Follow-Up Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Thais Bento Lima Da Silva ◽  
Tiago Nascimento Ordonez ◽  
Allan Gustavo Bregola ◽  
Valéria Santoro Bahia ◽  
Mário Amore Cecchini ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Neuropsychiatric Symptoms ◽  
Linear Regression Analysis ◽  
Predictor Variable ◽  
Wilcoxon Test ◽  
Chi Square ◽  
Behavioral Variant Frontotemporal Dementia

Introduction: Neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical managements.Objective: To test whether the Neuropsychiatry Inventory (NPI) could detect change in neuropsychiatric symptoms and caregiver's distress in patients diagnosed with behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) from baseline to a 12-month follow-up and to investigate possible predictors of change in NPI scores.Methods: The sample consisted of 31 patients diagnosed with bvFTD and 28 patients with AD and their caregivers. The Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination Revised (ACE-R), the INECO Frontal Screening (IFS), the Frontal Assessment Battery (FAB), the Executive Interview (EXIT-25) and the NPI were applied. Descriptive statistics, Mann-Whitney U test, Wilcoxon test, Chi square (χ2) test and Linear Regression Analysis were used.Results: NPI total and caregiver distress scores were statistically higher among bvFTD patients at both assessment points. MMSE, ACE-R scores significantly declined and NPI Total and Distress scores significantly increased in both groups. In the bvFTD group, age was the only independent predictor variable for the NPI total score at follow up. In the AD group, ACE-R and EXIT-25, conjunctively, were associated with the NPI total score at follow up.Conclusions: In 12 months, cognition declined and neuropsychiatric symptoms increased in bvFTD and AD groups. In the AD group only, cognitive impairment was a significant predictor of change in neuropsychiatric symptoms.

scholarly journals A systematic review of the prevalence of depression, anxiety, and apathy in frontotemporal dementia, atypical and young-onset Alzheimer’s disease, and inherited dementia

2020 ◽  
pp. 1-20
Author(s):  
Jessica D. Collins ◽  
Susie M. D. Henley ◽  
Aida Suárez-González
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Neuropsychiatric Symptoms ◽  
Primary Progressive Aphasia ◽  
Small Sample ◽  
Cortical Atrophy ◽  
Sample Sizes ◽  
Young Onset

ABSTRACT Objectives: Depression, anxiety, and apathy are the most commonly reported neuropsychiatric symptoms (NPS) in Alzheimer’s disease (AD). Understanding their prevalence in rarer dementias such as frontotemporal dementia (FTD), primary progressive aphasia (PPA), posterior cortical atrophy (PCA), young-onset AD (YOAD), and inherited dementias has implications for both clinical practice and research. In this study, we aimed to examine the current state of knowledge of the prevalence of these three NPS in less prevalent dementias. Design: We conducted a systematic review based on searches of EMBASE, PsycINFO, and PubMed up to September 2019. Results: 47 articles meeting inclusion criteria were identified. Depression, anxiety, and apathy were commonly reported across the phenotypes studied but their prevalence showed large variation between studies. Apathy showed the highest reported frequency in FTD (50–100% across studies), behavioral variant frontotemporal dementia (bvFTD) (73–100%), and YOAD (44–100%). Anxiety was frequently reported in FTD (0–100%) and bvFTD (19–63%). Depression showed the highest prevalence in FTD (7–69%) and YOAD (11–55%). Among the three variants of PPA, sv-PPA is the one most investigated (seven articles). Three or fewer articles were identified examining NPS in the remaining PPA variants, PCA, familial AD, and familial FTD. Inconsistency in the tools used to measure symptoms and small sample sizes were common methodological limitations. Conclusions: Future studies should consider the inclusion of larger sample sizes (e.g. through multicenter collaborations) and the use of harmonized protocols that include the combination of caregiver and patient-derived measures and symptom-specific questionnaires. More research is needed on the phenotype-specific barriers and facilitators for people living with dementia to successfully engage in self-reports of NPS.

Use of the Cognitive Estimations Test to Discriminate Frontotemporal Dementia from Alzheimer's Disease

1998 ◽  
Vol 11 (1) ◽  
pp. 2-6 ◽  
Author(s):  
Mario F. Mendez ◽  
Robert C. Doss ◽  
Monique M. Cherrier
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Neuropsychological Tests ◽  
Numerical Ability ◽  
Impaired Memory ◽  
Dementia Severity

This study investigated the cognitive estimations test (CET) in patients with frontotemporal dementia (FTD) and Alzheimer's disease (AD). The CET consists of questions which reflect judgment and reasoning. FTD patients, who have predominant frontotemporal atrophy, may give more extreme estimates on the CET compared to AD patients, who have greater temporoparietal pathology. The CET was administered to 31 FTD and 31 AD patients of comparable dementia severity plus 31 normal elderly controls. Both dementia groups gave significantly more extreme estimates on the CET than did the controls, and, contrary to expectations, AD patients gave more extreme estimates than did FTD patients. Extreme CET scores correlated with poor savings and calculations scores on neuropsychological tests. In conclusion, the CET may be particularly impaired in AD because it reflects impaired memory and numerical ability as well as disturbed judgment and reasoning. The CET may also be helpful in discriminating some patients in moderate stages of AD from those with FTD.

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