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P3‐026: Insight in frontotemporal dementia and Alzheimer's disease
Author(s) -
Lindau Maria P.,
Gunnarsson Malin Degerman,
Santillo Alexander Frizell,
Basun Hans,
Lannfelt Lars,
Kilander Lena
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.1589
Subject(s) - frontotemporal dementia , executive dysfunction , executive functions , psychology , neuropsychology , wisconsin card sorting test , dementia , frontotemporal lobar degeneration , episodic memory , cognition , neuropsychological assessment , neuropsychological test , disease , psychiatry , medicine , pathology
Background: Loss of insight occurs in frontotemporal dementia (FTD) and Alzheimer’s disease (AD). Since FTD is characterised by anterior cerebral neurodegeneration, and AD by posterior, insight in these disorders was hypothesised to be lost for different reasons. The aim was to compare insight in FTD and AD, and to investigate in which ways executive, emotional and cognitive aspects respectively may contribute to loss of insight. Methods: Ten FTD and ten AD patients participated. Patients were diagnosed by medical and neuropsychological examination, CT and PET scans. Insight was assessed by quantified interviews concerning diagnoses, symptoms, association of symptoms with illness, adaptation to changes, signs of living in the past, extenuation of difficulties, projections, unconcern and reduced ability to reason. The results of the interviews were compared to neuropsychological tests and CT/PET. Results: FTD patients were more unconcerned (p .03) than AD patients, whereas AD patients had taken more measures to adapt (Fig.1, p .02). In FTD awareness of cognitive problems was related to clock drawing (p .05), as was adaptation to problems (p .05). Adaptation was also correlated to the Wisconsin Card Sorting test (WCST, p .03). In AD awareness of cognitive problems and personality were associated with verbal episodic memory (p .04; p .01). Verbal episodic memory was also correlated to adaptation (p .04). Conclusions: Two types of insight emerge: In FTD loss of insight was associated with executive dysfunction (clock drawing, WCST), and with unconcern about the consequences of the disease (loss of executive insight). In AD concern about the situation may explain the higher efforts to adapt to e.g. memory problems (cognitive insight). ROI-PET analyses will yield more specific information about the localisation of deficits in insight.