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Which neuropsychiatric and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease
BOZEAT, S., Gregory, C.A., LAMBON RALPH, M.A. & HODGES , J.R.
Journal of Neurology, Neurosurgery & Psychiatry 2000; 69; 178-186
Year of publication:
The aim of this study was to investigate the prevalence of changes in mood, personality and behaviour in frontotemporal dementia (FTD) and Alzheimer's disease and hence, which features reliably distinguish between them. A questionnaire was designed to assess a wide range of neuropsychiatric changes, it incorporated features reported in previous studies of FTD and components of the Neuropsychiatric Inventory. This was completed by 37 carers of patients with Alzheimer's disease and 33 patients with frontotemporal dementia, comprising 20 with temporal variant FTD or semantic dementia and 13 with frontal variant FTD. Factor analysis revealed four robust and meaningful symptom clusters: Factor 1 - stereotypic and eating behaviour; Factor 2 - executive dysfunction and self care; Factor 3 - mood changes; Factor 4 - loss of social awareness. Only stereotypic and altered eating behaviour, and loss of social awareness, reliably differentiated AD from FTD with no effect of disease severity. By contrast, executive dysfunction, poor self-care and restlessness showed a significant effect of disease severity only, with the more impaired patients scoring more highly. Changes in mood were found to be equally prevalent in the three patient groups. Analysis of individual symptoms revealed elevated rates of mental rigidity and depression in the patients with semantic dementia compared to those with fv FTD. Conversely, the latter group showed greater disinhibition.