engleski

Clinical and Psychometric Distinction of Frontotemporal and Alzheimer's Dementias

A proportion of patients who meet the NINCDS-ADRDA criteria for Alzheimers disease (AD) have frontotemporal lobar degeneration (FTLD) confirmed at autopsy, with or without concomitant AD. Thus, the clinical phenotypes of the two disorders may overlap. To identify clinical and psychometric indicators that distinguish AD from FTLD at initial presentation. Design Longitudinal study of memory and aging. Settings Alzheimer's Disease Research Center, Washington University, St. Louis, MO Participants Forty-eight clinically well-characterized cases of autopsy-confirmed FTLD (27 with psychometric testing) were compared with 27 autopsy-confirmed AD cases. Behavioral abnormalities, particularly impulsivity (p < .0001), disinhibition (p =. 0004), social withdrawal (p= .01), and progressive nonfluent aphasia distinguished FTLD and AD individuals. The FTLD individuals performed better than those with AD on a visual test of episodic memory (p < .05), but worse on word fluency (p < .05) (performance correlated with aphasic features). Other cognitive and clinical features, including executive dysfunction and memory impairment, were comparable between the FTLD and AD groups. Concomitant histopathological AD was present in 11 of the 48 FTLD individuals. Clinical and cognitive features of FTLD may overlap with AD, although behavioral and language difficulties distinguish those with FTLD. Memory loss in FTLD may in part reflect word-finding difficulties stemming from language dysfunction. Compounding the overlap of FTLD and AD clinical phenotypes is the presence of histopathological AD in almost one-fourth of FTLD individuals.

frontotemporal dementia; Alzheimer dementia; clinical and psychological assessment

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