title: Using the revised diagnostic criteria for frontotemporal dementia in India: evidence of an advanced and florid disease.
abstract: BACKGROUND
  The International Consortium (FTDC) that revised the diagnostic criteria for behavioural variant frontotemporal dementia (bvFTD) did not have an Asian representation. Whether the revised criteria are equally useful in the early detection of Asian bvFTD patients therefore remains largely unexplored. Earlier studies have indicated differences in clinical manifestations in Indian and other Asian bvFTD patients when compared to western groups. There is an urgent need for clarification, given the projected exponential rise in dementia in these countries and the imminent clinical trials on bvFTD.
  
  
  OBJECTIVE
  To assess how Indian bvFTD patients fulfil the FTDC criteria, hypothesizing that our patients might present differently early in the illness.
  
  
  METHODS
  In a hospital-based retrospective observational study, we assessed 48 probable bvFTD patients, diagnosed according to the FTDC criteria, for the speed with which these criteria were fulfilled, the frequency of individual symptoms and their order of appearance during the illness.
  
  
  RESULTS
  Most of our patients presented with moderate to severe dementia, in spite of having relatively short onset to diagnosis times. Patients on average took 1.4 years from onset to meet the FTDC criteria, with 90% of them presenting with four or more symptoms at diagnosis. Disinhibition was the commonest symptom and the first symptom in most patients.
  
  
  CONCLUSIONS
  With most patients presenting with advanced and florid disease, the FTDC criteria have little additional impact in early identification of bvFTD in India. Modifying the criteria further could allow detection of Indian patients early enough for their inclusion in future clinical trials.
authors.affiliation: Department of Neurology and Cognitive Neurology Unit, Apollo Gleneagles Hospitals, Kolkata, India. amitabha.ghosh@yahoo.co.in
authors.forename: Amitabha
authors.initials: A
authors.lastname: Ghosh
authors.forename: Aparna
authors.initials: A
authors.lastname: Dutt
authors.forename: Madhura
authors.initials: M
authors.lastname: Ghosh
authors.forename: Pallavi
authors.initials: P
authors.lastname: Bhargava
authors.forename: Sulakshana
authors.initials: S
authors.lastname: Rao
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D057180:Frontotemporal Dementia / Q000175:diagnosis*; D006801:Humans; D007194:India; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies