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Differentiating the frontal variant of Alzheimer's disease
Author(s) -
Woodward Michael,
Jacova Claudia,
Black Sandra E,
Kertesz Andrew,
Mackenzie Ian R.,
Feldman Howard
Publication year - 2010
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2415
Subject(s) - frontotemporal dementia , dementia , clinical dementia rating , psychology , cohort , disease , alzheimer's disease , apolipoprotein e , age of onset , psychiatry , pathological , medicine
Objective Individuals with a clinical diagnosis of Alzheimer's disease (AD) may have prominent features of executive dysfunction and language impairment as well as behavioral abnormalities early in the disease (‘high frontality’). When this occurs differentiation from frontotemporal dementia (FTD) is difficult. It is hypothesized that AD patients with high frontality may have clinical and pathological features that distinguish them from less frontal AD patients. Methods In a well‐characterized cohort of people with cognitive impairment, we used the Frontal Behavioral Inventory (FBI) in an attempt to identify AD patients with prominent frontal features (high‐FBI AD) and distinguish them from the remainder of AD patients (low‐FBI AD). Results The 18 high‐FBI AD patients were compared with the 26 FTD patients who had an FBI performed and the 53 other low FBI AD patients. The individual FBI items did not differ significantly between the FTD and the high‐FBI AD patients, and the high FBI AD patients were more like the FTD patients than the other AD patients with respect to presence of a family history of AD, proportion with homozygous apolipoprotein E 4 status, disability as measured by the Disability Assessment for Dementia (DAD) Scale and the Functional Rating Scale (FRS) and neuropsychiatric impairment as measured by the Neuropsychiatric Inventory (NPI). Memory symptom duration was similar in the high FBI AD group compared to the low FBI AD group. Conclusions There is a subgroup of AD patients with high frontality that can be clinically distinguished from the remainder of AD patients but which requires pathological verification. Copyright © 2009 John Wiley & Sons, Ltd.