Can frontotemporal dementia and Alzheimer's disease be differentiatedusing a brief battery of tests?
C.A. Gregory
Bok Engelsk 1997
| Utgitt | 1997
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| Omfang | Side 375- 383
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| Opplysninger | Objective. To compare the performance of patients with frontotemporaldementia (FTD) and Alzheimer's disease (AD) on a range of simpleneuropsychological tests.Design. A battery of neuropsychological tests easily applied at thebedside, consisting of traditional tests of memory, attention andexecutive function, were given together with tests of motorsequencing and examination of frontal release signs. In addition, wedevised a theoretically motivated test of dual attention-a story withdistraction which also contained a 'social dilemma'.Setting. Specialist memory and cognitive disorders clinic.Patients. 12 patients with FTD and 12 patients with AD, matched foroverall level of dementia on the Mini-Mental State Examination, wereselected.Results. In general, the difference in results between FTD and ADpatients was small. However, a composite score derived from thepresence of a grasp and pout reflex, the number of perseverationsduring category fluency for animals and response to the socialdilemma within the two stories produced a sensitivity of 83.3% andspecificity of 91.6%. There was also a highly significant differencebetween patients with FTD and AD in scores achieved on the ClinicalDementia Rating Scale reflecting the marked change in behaviour thatpatients with FTD suffer, even at a stage when memory functions arewell preserved.Conclusion. Traditional neuropsychological tests were poor atdifferentiating cases of FTD and AD; however, a composite (SIFTD)score appears potentially useful but requires prospective validation.Better methods of assessing the changes in comportment thatcharacterize the early stages of FTD are required. ((C) 1997 by JohnWiley & Sons, Ltd.)
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