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Validation of The Edinburgh cognitive and behavioural ALS screen (ECAS) in behavioural variant frontotemporal dementia and Alzheimer’s disease
Author(s) -
De Icaza Valenzuela Mónica M.,
Bak Thomas H.,
Thompson Harriet E.,
Colville Shuna,
Pal Suvankar,
Abrahams Sharon
Publication year - 2021
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.5566
Subject(s) - frontotemporal dementia , neuropsychology , psychology , amyotrophic lateral sclerosis , dementia , cognition , neuropsychological assessment , audiology , executive functions , verbal fluency test , clinical psychology , psychiatry , disease , medicine
The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was developed to assess cognitive and behavioural changes in an anterior frontotemporal syndrome (executive functions, language, fluency and behaviour), common in Amyotrophic Lateral Sclerosis (ALS) and also assesses posterior cerebral dysfunction (memory and visuospatial abilities). Objectives To validate the ECAS in behavioural variant Frontotemporal Dementia (bvFTD) without ALS, as compared with Alzheimer’s disease (AD), against comprehensive neuropsychological assessment. Compare its sensitivity to that of the Addenbrooke’s Cognitive Examination (ACE‐III) and investigate behavioural changes in both types of dementia. Methods Retrospective study of 16 people with bvFTD (without ALS), 32 with AD, and 48 healthy controls completed the ECAS, ACE‐III and extensive neuropsychological assessment. Results The ECAS showed higher sensitivity (94%) and marginally lower specificity (96%) than the ACE‐III for both the bvFTD and AD groups. The anterior composite subscore was sensitive for bvFTD (94%), and slightly less so for AD (84%), while the posterior composite subscore was sensitive for AD (97%), and less so for bvFTD (75%). All people with bvFTD that were impaired on the ECAS total and anterior composite scores were also impaired on the anterior function’s tests of the neuropsychological assessment. A cut‐off of four or more behavioural domains affected differentiated well between the bvFTD and AD groups, while a qualitative analysis of the behavioural interview found different themes between groups. Conclusions The ECAS is a valid and sensitive assessment for bvFTD without ALS and for AD. The carer behavioural interview makes it particularly suitable to detect behavioural abnormalities related to frontal lobe disorders