Relation between frontal lobe symptoms and dementia severity within and across diagnostic dementia categories.
BACKGROUND
To study frontal lobe symptoms in relation to dementia severity within and across diagnostic dementia categories, a cross-sectional analysis of behavioural data was performed.


METHODS
Patients with probable Alzheimer's disease (AD) (n = 456), frontotemporal dementia (FTD) (n = 55) and dementia with Lewy bodies (DLB) (n = 48) were included. Dementia severity and frontal lobe symptoms were assessed by means of the global deterioration scale and the Middelheim frontality score (MFS).


RESULTS
In FTD, no difference in MFS total scores between patients belonging to the mild and severe dementia stages was found (p = 0.828). In AD and DLB groups, significantly higher MFS total scores were found in severe dementia stages compared to mild dementia stages (p < 0.001). Comparing MFS total scores between FTD and AD patients, significantly higher scores were achieved in FTD patients, irrespective of dementia severity (p < 0.001).


CONCLUSIONS
In FTD patients, frontal lobe symptoms were severe in the mild, moderate and severe dementia stages although the nature of frontal lobe symptoms depended on disease severity. AD and DLB patients displayed more frontal lobe symptoms in the advanced disease stages as compared to disease onset, suggesting gradual frontal lobe involvement as the disease progresses. The nature of frontal lobe symptoms related to dementia severity differed between AD, DLB and FTD patients, suggesting different patterns of frontal lobe involvement. Last but not the least, these data point to the potential diagnostic value of behavioural observation of frontal lobe symptoms for (differential) dementia diagnosis, especially at the earliest disease stages. These findings await confirmation through a prospective, longitudinal study.
Department of Neurology and Memory Clinic, Middelheim and Hoge Beuken General Hospitals ZNA, University of Antwerp, Antwerp, Belgium.
Marcel J H
MJ
Aries
Nathalie
N
Le Bastard
Hans
H
Debruyne
Michael
M
Van Buggenhout
Guy
G
Nagels
Peter Paul
PP
De Deyn
Sebastiaan
S
Engelborghs
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D000704:Analysis of Variance; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology*; D001530:Belgium / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D012737:Sex Factors