title: Activities of daily living in frontotemporal dementia and Alzheimer disease.
abstract: OBJECTIVE
  To evaluate activities of daily living (ADLs) in three clinical variants of frontotemporal dementia and the relationship to cognitive dysfunction.
  
  
  METHODS
  Fifty-nine patients and caregivers participated in this cross-sectional study: behavioral variant frontotemporal dementia (bv-FTD, n = 15), progressive nonfluent aphasia (PNFA, n = 10), semantic dementia (n = 15), and Alzheimer disease (AD, n = 19). Caregivers were interviewed with the Disability Assessment for Dementia (DAD) to provide two outcome measures about ADLs: basic and instrumental ADLs (BADLs, IADL). In addition, patients were rated on the Clinical Dementia Rating Scale (CDR), and performance on cognitive measures (Addenbrooke's Cognitive Examination Revised [ACE-R]) was assessed.
  
  
  RESULTS
  On the DAD, the bv-FTD group was most affected (56% of normal), whereas PNFA and semantic dementia patients were least impaired (83% and 85%); AD was intermediate (76%). The opposite pattern was seen on the ACE-R, where PNFA and semantic dementia groups were most affected, and bv-FTD showed least impairment; AD was again intermediate. Scores on the DAD did not correlate with cognitive measures, CDR, or disease duration. We further analyzed which aspect of ADLs was most affected, and a unique pattern of deficits emerged for the bv-FTD group (initiation affected > planning > execution for BADLs).
  
  
  CONCLUSIONS
  Frontotemporal dementia has a devastating effect on activities of daily living, which is of considerable importance to caregivers and not captured by bedside cognitive tests.
authors.affiliation: University of Cambridge Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: E
authors.initials: E
authors.lastname: Mioshi
authors.forename: C M
authors.initials: CM
authors.lastname: Kipps
authors.forename: K
authors.initials: K
authors.lastname: Dawson
authors.forename: J
authors.initials: J
authors.lastname: Mitchell
authors.forename: A
authors.initials: A
authors.lastname: Graham
authors.forename: J R
authors.initials: JR
authors.lastname: Hodges
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D017677:Age Distribution; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards; D011237:Predictive Value of Tests; D017678:Sex Distribution