Translation, cross-cultural adaptation and applicability of the Brazilian version of the Frontotemporal Dementia Rating Scale (FTD-FRS).

Thais Bento Lima-Silva,Sônia Maria Dozzi Brucki,Viviane Amaral Carvalho,Cássio Machado De Campos Bottino,Márcio Balthazar,Ricardo Nitrini,Eneida Mioshi,Mônica Sanches Yassuda,Paulo Caramelli,Valéria Santoro Bahia,Henrique Cerqueira Guimarães,Benito Damasceno

doi:10.1590/s1980-57642013dn74000006

Abstract

BACKGROUNDStaging scales for dementia have been devised for grading Alzheimer's disease (AD) but do not include the specific symptoms of frontotemporal lobar degeneration (FTLD).OBJECTIVETo translate and adapt the Frontotemporal Dementia Rating Scale (FTD-FRS) to Brazilian Portuguese.METHODSThe cross-cultural adaptation process consisted of the following steps: translation, back-translation (prepared by independent translators), discussion with specialists, and development of a final version after minor adjustments. A pilot application was carried out with 12 patients diagnosed with bvFTD and 11 with AD, matched for disease severity (CDR=1.0). The evaluation protocol included: Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini-Mental State Examination (MMSE), Executive Interview (EXIT-25), Neuropsychiatric Inventory (NPI), Frontotemporal Dementia Rating Scale (FTD-FRS) and Clinical Dementia Rating scale (CDR).RESULTSThe Brazilian version of the FTD-FRS seemed appropriate for use in this country. Preliminary results revealed greater levels of disability in bvFTD than in AD patients (bvFTD: 25% mild, 50% moderate and 25% severe; AD: 36.36% mild, 63.64% moderate). It appears that the CDR underrates disease severity in bvFTD since a relevant proportion of patients rated as having mild dementia (CDR=1.0) in fact had moderate or severe levels of disability according to the FTD-FRS.CONCLUSIONThe Brazilian version of the FTD-FRS seems suitable to aid staging and determining disease progression.

Highlights

The term Frontotemporal Lobar Degeneration (FTLD) was first introduced in 1998 by a group of Swedish and English researchers,[1] who used it to describe a clinical syndrome characterized by progressive behavioral changes associated with atrophy of the frontal lobes and of the anterior portions of the temporal lobes
Three main conditions are described in the frontotemporal lobar degeneration (FTLD) group: frontotemporal dementia (FTD) or behavioral variant frontotemporal dementia,[2,3] semantic dementia (SD),[4] and progressive non-fluent aphasia (PNFA).[4,5,6]
We present a culturally adapted, translated version of the FTD-Frontotemporal Dementia Rating Scale (FRS) in Brazilian Portuguese

Summary

INTRODUCTION

The term Frontotemporal Lobar Degeneration (FTLD) was first introduced in 1998 by a group of Swedish and English researchers,[1] who used it to describe a clinical syndrome characterized by progressive behavioral changes associated with atrophy of the frontal lobes and of the anterior portions of the temporal lobes. A recently developed scale designed to examine the behavioral and functional changes associated with FTLD, the Frontotemporal Dementia Rating Scale (FTD-FRS), has been found to be helpful for assessing severity and the rate of functional decline.[8]. In the validation study of the FTD-FRS,[8] by crosssectional analyses involving a sample with three FTLD variants (bvFTD, n=29; SD, n=20; PNFA, n=28), the authors were able to identify six levels of disease severity (very mild, mild, moderate, severe, very severe and advanced/profound) with the use of the FTD-FRS. The primary aim of the present study was to translate the FTD-FRS to Brazilian Portuguese and adapt it to the Brazilian cultural context

METHODS

1.47 Moderate

RESULTS

DISCUSSION