Title | Combined Socio-Behavioral Evaluation Improves the Differential Diagnosis Between the Behavioral Variant of Frontotemporal Dementia and Alzheimer's Disease: In Search of Neuropsychological Markers. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Dodich, A, Cerami, C, Cappa, SF, Marcone, A, Golzi, V, Zamboni, M, Giusti, MCristina, Iannaccone, S |
Journal | J Alzheimers Dis |
Volume | 61 |
Issue | 2 |
Pagination | 761-772 |
Date Published | 2018 |
ISSN | 1875-8908 |
Keywords | Aged, Aged, 80 and over, Alzheimer Disease, Biomarkers, Cognition, Diagnosis, Differential, Female, Frontotemporal Dementia, Humans, Logistic Models, Male, Memory, Episodic, Mental Recall, Middle Aged, Neuropsychological Tests, Retrospective Studies, Social Skills |
Abstract | BACKGROUND: Current diagnostic criteria for behavioral variant of frontotemporal dementia (bvFTD) and typical Alzheimer's disease (AD) include a differential pattern of neuropsychological impairments (episodic memory deficit in typical AD and dysexecutive syndrome in bvFTD). There is, however, large evidence of a frequent overlap in neuropsychological features, making the differential diagnosis extremely difficult. OBJECTIVES: In this retrospective study, we evaluated the diagnostic value of different cognitive and neurobehavioral markers in bvFTD and AD patient groups. METHODS: We included 95 dementia patients with a clinical and biomarker evidence of bvFTD (nā=ā48) or typical AD (nā=ā47) pathology. A clinical 2-year follow-up confirmed clinical classification. Performances at basic cognitive tasks (memory, executive functions, visuo-spatial, language) as well as social cognition skills and neurobehavioral profiles have been recorded. A stepwise logistic regression model compared the neuropsychological profiles between groups and assessed the accuracy of cognitive and neurobehavioral markers in discriminating bvFTD from AD. RESULTS: Statistical comparison between patient groups proved social cognition and episodic memory impairments as main cognitive signatures of bvFTD and AD neuropsychological profiles, respectively. Only half of bvFTD patients showed attentive/executive deficits, questioning their role as cognitive marker of bvFTD. Notably, the large majority of bvFTD sample (i.e., 70%) poorly performed at delayed recall tasks. Logistic regression analysis identified social cognition performances, Frontal Behavioral Inventory and Mini-Mental State Examination scores as the best combination in distinguishing bvFTD from AD. CONCLUSION: Social cognition tasks and socio-behavioral questionnaires are recommended in clinical settings to improve the accuracy of early diagnosis of bvFTD. |
DOI | 10.3233/JAD-170650 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 29254091 |