scholarly journals Longitudinal change in everyday function and behavioral symptoms in frontotemporal dementia

2016 ◽  
Vol 6 (5) ◽  
pp. 419-428 ◽  
Author(s):  
Claire M. O'Connor ◽  
Lindy Clemson ◽  
Michael Hornberger ◽  
Cristian E. Leyton ◽  
John R. Hodges ◽  
...  
Keyword(s):  
Frontotemporal Dementia ◽  
Longitudinal Change ◽  
Behavioral Symptoms ◽  
Everyday Function

scholarly journals A Comparative Study of the Behavioral Profile of the Behavioral Variant of Frontotemporal Dementia and Parkinson’s Disease Dementia

2020 ◽  
pp. 182-194
Author(s):  
Dinesh Saini ◽  
Adreesh Mukherjee ◽  
Arijit Roy ◽  
Atanu Biswas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Frontotemporal Dementia ◽  
Severe Disease ◽  
Executive Dysfunction ◽  
Behavioral Symptoms ◽  
Parkinson’S Disease Dementia ◽  
Subcortical Dementia ◽  
Behavioral Profile ◽  
Cortical Dementia

<b><i>Background:</i></b> Executive dysfunction is the common thread between pure cortical dementia like the behavioral variant of frontotemporal dementia (bvFTD) and subcortical dementia like Parkinson’s disease dementia (PDD). Although there are clinical and cognitive features to differentiate cortical and subcortical dementia, the behavioral symptoms differentiating these 2 conditions are still not well known. <b><i>Objective:</i></b> To evaluate the behavioral profile of bvFTD and PDD and compare them to find out which behavioral symptoms can differentiate between the two. <b><i>Methods:</i></b> Twenty consecutive patients with bvFTD (&#x3e;1 year after diagnosis) and 20 PDD patients were recruited according to standard diagnostic criteria. Behavioral symptoms were collected from the reliable caregiver by means of a set of questionnaires and then compared between the 2 groups. <b><i>Results:</i></b> bvFTD patients had more severe disease and more behavioral symptoms than PDD. bvFTD patients were different from PDD patients due to their significantly greater: loss of basic emotion (<i>p</i> &#x3c; 0.001, odds ratio [OR] 44.33), loss of awareness of pain (<i>p</i> &#x3c; 0.001, OR 44.33), disinhibition (<i>p</i> &#x3c; 0.001, OR 35.29), utilization phenomenon (<i>p</i> = 0.008, OR 22.78), loss of taste discrimination (<i>p</i> &#x3c; 0.001, OR 17), neglect of hygiene (<i>p</i> = 0.001, OR 13.22), loss of embarrassment (<i>p</i> = 0.003, OR 10.52), wandering (<i>p</i> = 0.004, OR 9.33), pacing (<i>p</i> = 0.014, OR 9), selfishness (<i>p</i> = 0.014, OR 9), increased smoking (<i>p</i> = 0.014, OR 9), increased alcohol consumption (<i>p</i> = 0.031, OR 7.36), social avoidance (<i>p</i> = 0.012, OR 6.93), mutism (<i>p</i> = 0.041, OR 5.67), and failure to recognize objects (<i>p</i> = 0.027, OR 4.33). The bvFTD patients were also significantly less suspicious (<i>p</i> = 0.001, OR 0.0295), less inclined to have a false belief that people were in their home (<i>p</i> = 0.014, OR 0.11) and had fewer visual illusions/hallucinations (<i>p</i> = 0.004, OR 0.107) than PDD patients. <b><i>Conclusion:</i></b> Behavioral symptoms are helpful to distinguish bvFTD from PDD, and thus also cortical dementia with frontal-lobe dysfunction from subcortical dementia.

scholarly journals Qualitative Assessment of Verbal Fluency Performance in Frontotemporal Dementia

2017 ◽  
Vol 44 (1-2) ◽  
pp. 35-44 ◽  
Author(s):  
Esther van den Berg ◽  
Lize C. Jiskoot ◽  
Mariëlle J.H. Grosveld ◽  
John C. van Swieten ◽  
Janne M. Papma
Keyword(s):  
Executive Functioning ◽  
Frontotemporal Dementia ◽  
Verbal Fluency ◽  
Verbal Ability ◽  
Primary Progressive Aphasia ◽  
Longitudinal Change ◽  
Qualitative Assessment ◽  
Semantic Fluency ◽  
Additional Information ◽  
With Memory

Background/Aims: Verbal fluency is impaired in patients with frontotemporal dementia (FTD) and primary progressive aphasia (PPA). This study explored qualitative differences in verbal fluency (clustering of words, switching between strategies) between FTD and PPA variants. Methods: Twenty-nine patients with behavioral variant FTD (bvFTD) and 50 with PPA (13 nonfluent/agrammatic, 14 semantic, and 23 logopenic) performed a semantic and letter fluency task. Clustering (number of multiword strings) and switching (number of transitions between clustered and nonclustered words) were recorded by two independent raters. Between-group differences, associations with memory, language, and executive functioning, and longitudinal change (subsample) in clustering and switching were examined. Results: Interrater reliability was high (median 0.98). PPA patients generated (a) smaller (number of) clusters on semantic and letter fluency than bvFTD patients (p < 0.05). Semantic variant patients used more switches than nonfluent/agrammatic or logopenic variant patients (p < 0.05). Clustering in semantic fluency was significantly associated with memory and language (range standardized regression coefficients 0.24-0.38). Switching in letter fluency was associated with executive functioning (0.32-0.35). Conclusion: Clustering and switching in verbal fluency differed between patients with subtypes of FTD and PPA. Qualitative aspects of verbal fluency provide additional information on verbal ability and executive control which can be used for clinically diagnostic purposes.

scholarly journals Apathy and functional disability in behavioral variant frontotemporal dementia

2018 ◽  
Vol 8 (2) ◽  
pp. 120-128 ◽  
Author(s):  
Mônica S. Yassuda ◽  
Thais B. Lima da Silva ◽  
Claire M. O'Connor ◽  
Shailaja Mekala ◽  
Suvarna Alladi ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Functional Impairment ◽  
Cognitive Deficits ◽  
Daily Living ◽  
Functional Disability ◽  
Motor Behavior ◽  
Regression Analyses ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Everyday Function

BackgroundBehavioral variant frontotemporal dementia (bvFTD) has profound consequences on patients and their families. In this multicenter study, we investigated the contribution of cognitive and neuropsychiatric factors to everyday function at different levels of overall functional impairment.MethodsIn a retrospective cross-sectional study, 109 patients with bvFTD from 4 specialist frontotemporal dementia centers (Australia, England, India, and Brazil) were included. The measures administered evaluated everyday function (Disability Assessment for Dementia [DAD]), dementia staging (Clinical Dementia Rating [CDR]), general cognition (Addenbrooke's Cognitive Examination–revised [ACE-R]), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). Patients were then subdivided according to functional impairment on the DAD into mild, moderate, severe, and very severe subgroups. Three separate multiple linear regression analyses were run, where (1) total DAD, (2) basic activities of daily living (BADL), and (3) instrumental activities of daily living (IADL) scores were dependent variables; ACE-R total score and selected NPI domains (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) were used as independent variables. Age, sex, education, and country of origin were controlled for in the analyses.ResultsCognitive deficits were similar across the mild, moderate, and severe subgroups but significantly worse in the very severe subgroup. NPI domain scores (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) did not differ across the DAD subgroups. In the multiple regression analyses, a model including ACE-R and NPI apathy explained 32.5% of the variance for total DAD scores. For IADL, 35.6% of the variance was explained by the ACE-R only. No model emerged for BADL scores.ConclusionsCognitive deficits and apathy are key contributors to functional disability in bvFTD but factors underlying impairment in BADLs remain unclear. Treatments targeting reduction of disability need to address apathy and cognitive impairment to ensure greater efficacy, especially in regards to IADLs.

scholarly journals Executive Dysfunction and Behavioral Symptoms Are Associated with Deficits in Instrumental Activities of Daily Living in Frontotemporal Dementia

2017 ◽  
Vol 43 (1-2) ◽  
pp. 89-99 ◽  
Author(s):  
Negar Moheb ◽  
Mario F. Mendez ◽  
Sarah A. Kremen ◽  
Edmond Teng
Keyword(s):  
Activities Of Daily Living ◽  
Frontotemporal Dementia ◽  
Daily Living ◽  
Primary Progressive Aphasia ◽  
Executive Dysfunction ◽  
Behavioral Symptoms ◽  
Data Set ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Instrumental Activities

Background: Deficits in instrumental activities of daily living (ADLs) may be more prominent in behavioral variant frontotemporal dementia (bvFTD) than in nonfluent/agrammatic variant primary progressive aphasia (nfvPPA) or semantic variant primary progressive aphasia (svPPA). It is uncertain whether frontotemporal dementia (FTD) subgroups exhibit different patterns and/or predictors of functional impairment. Methods: We examined data from participants diagnosed with bvFTD (n = 607), svPPA (n = 132), and nfvPPA (n = 155) who were included in the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) and assessed with the Functional Activities Questionnaire (FAQ). Stepwise multiple linear regression analyses were performed to identify associations between FAQ scores and cognitive/behavioral deficits using the NACC UDS neuropsychological testing battery and the Neuropsychiatric Inventory Questionnaire. Results: FAQ scores were higher in bvFTD than svPPA or nfvPPA. Functional deficits across FTD subtypes differed in severity, but not pattern, and were driven by executive dysfunction and behavioral symptoms. Conclusion: Executive dysfunction and behavioral symptoms underlie instrumental ADL deficits in FTD, which are most prominent in bvFTD.

Behavioral Phenomenology in Alzheimer's Disease, Frontotemporal Dementia, and Late-Life Depression: A Retrospective Analysis

1997 ◽  
Vol 10 (2) ◽  
pp. 67-74 ◽  
Author(s):  
J. Randolph Swartz ◽  
Bruce L. Miller ◽  
Ira M. Lesser ◽  
Ruth Booth ◽  
Amy Darby ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Discriminant Analysis ◽  
Frontotemporal Dementia ◽  
Diagnostic Category ◽  
Late Life ◽  
Behavioral Symptoms ◽  
Stepwise Discriminant Analysis ◽  
Late Life Depression ◽  
Behavioral Abnormalities

Often patients in the early stages of Alzheimer's disease (AD), frontotemporal dementia (FTD), and late-life depression can be difficult to differentiate clinically. Although subtle cognitive distinctions exist between these disorders, noncognitive behavioral phenomenology may provide additional discriminating power. In 19 subjects with AD, 19 with FTD, 16 with late-life psychotic depression (LLPD), and 19 with late-life nonpsychotic depression (LLNPD), noncognitive behavioral symptoms were quantified retrospectively using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and compared using both a one-way ANOVA and a multivariate stepwise discriminant analysis, which utilized a jackknife procedure. The FTD group showed the highest mean total SCAN score, while the AD group showed the lowest. ANOVA showed significant differences in the mean total SCAN scores between the four diagnostic groups ( P < .0001). With the discriminant analysis, the four disorders demonstrated different clusters of behavioral abnormalities and were differentiated by these symptoms ( P < .0001). A subset of 14 SCAN item group symptoms was identified that collectively classified correctly the following percentages of subjects in each diagnostic category: AD 94.7%, FTD 100%, LLPD 87.5%, and LLNPD 100%. These results indicate that AD, FTD, LLPD, and LLNPD were distinguished retrospectively by the SCAN without using cognitive data. Better definition of the longitudinal course of noncognitive behavioral symptoms in different dementias and psychiatric disorders will be valuable both for diagnosis and to help define behavioral syndromes that are associated with selective neuroanatomic and neurochemical brain pathology.

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