Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease: A 12-Month Follow-Up Study.

Thais Bento Lima Da Silva,Tiago Nascimento Ordonez,Mário Amore Cecchini,Monica Sanches Yassuda,Paulo Caramelli,Sonia Maria Dozzi Brucki,Henrique Cerqueira Guimarães,Allan Gustavo Bregola,Leandro Boson Gambogi,Leonardo Cruz De Souza,Valéria Santoro Bahia,Benito Pereira Damasceno,Ricardo Nitrini,Marcio Luiz Figueredo Balthazar

doi:10.3389/fneur.2021.728108

Abstract

Introduction: Neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical managements.Objective: To test whether the Neuropsychiatry Inventory (NPI) could detect change in neuropsychiatric symptoms and caregiver's distress in patients diagnosed with behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) from baseline to a 12-month follow-up and to investigate possible predictors of change in NPI scores.Methods: The sample consisted of 31 patients diagnosed with bvFTD and 28 patients with AD and their caregivers. The Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination Revised (ACE-R), the INECO Frontal Screening (IFS), the Frontal Assessment Battery (FAB), the Executive Interview (EXIT-25) and the NPI were applied. Descriptive statistics, Mann-Whitney U test, Wilcoxon test, Chi square (χ2) test and Linear Regression Analysis were used.Results: NPI total and caregiver distress scores were statistically higher among bvFTD patients at both assessment points. MMSE, ACE-R scores significantly declined and NPI Total and Distress scores significantly increased in both groups. In the bvFTD group, age was the only independent predictor variable for the NPI total score at follow up. In the AD group, ACE-R and EXIT-25, conjunctively, were associated with the NPI total score at follow up.Conclusions: In 12 months, cognition declined and neuropsychiatric symptoms increased in bvFTD and AD groups. In the AD group only, cognitive impairment was a significant predictor of change in neuropsychiatric symptoms.

Highlights

Neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical managements
Behavioral variant frontotemporal dementia is a neurodegenerative syndrome which is usually diagnosed in midlife
In Behavioral variant frontotemporal dementia (bvFTD), identifying neuropsychiatric symptoms and following them up over time is relevant for treatment and disease management, as they may relate to the progressive decline in social and emotional functions

Summary

Introduction

Neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical managements. Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative syndrome which is usually diagnosed in midlife (mean age at onset around 58 years). BvFTD is the most common one as it represents 50% of the cases [1]. The diagnosis of bvFTD is a challenging one, mainly in the initial stage of the disease, when its clinical expression is limited to personality and behavioral changes [2]. Close inspection of behavioral changes could support accurate differential diagnosis from psychiatric diseases and other dementias [3]. In bvFTD, identifying neuropsychiatric symptoms and following them up over time is relevant for treatment and disease management, as they may relate to the progressive decline in social and emotional functions. During bvFTD course, apathy can be the most frequent and intense symptom [2, 4]

Methods

Results

Conclusion