Trajectories of Behavioural Disturbances Across Dementia Types.
OBJECTIVE
To replicate a previous finding that the trajectory of the Neuropsychiatric Inventory (NPI) shifts in the sixth year of behavioural variant frontotemporal dementia (bvFTD). We evaluated longitudinal tracking with both the Frontal Behavioural Inventory (FBI) and NPI, comparing bvFTD against other dementias.


METHODS
Chart reviews over two to five years for patients with bvFTD (n=30), primary progressive aphasia (PPA, n=13) and Alzheimer's disease (AD, n=118) at an urban Canadian tertiary clinic specializing in dementia. Linear regressions of the longitudinal data tested predictors of annualized rates of change (ROC) in NPI and FBI total and subscales for apathy and disinhibition among dementia groups.


RESULTS
The mode of the overall sample for the most advanced duration of illness observed was 5 years, with the median at 7 years. We did not find a crescendo-decrescendo pattern in scores although, for bvFTD and AD, high initial scores correlated with ensuing downward ROCs on the NPI and FBI. Educational level showed an influence on disinhibition ROCs. The FBI was no more revealing than the NPI for apathy and disinhibition scores in these dementias.


CONCLUSIONS
A cognitive reserve effect on behavioural disturbance was supported but it may take longer than our 4 years of observing the clinical sample to record inflection points in the behavioural and psychiatric symptoms seen in bvFTD. The current data only imply that both apathy and disinhibition will diminish over the course of dementia.
2Rotman Research Institute of Baycrest,Mt. Sinai,Toronto,Ontario,Canada.
Alexandra B
AB
Linds
1Faculty of Health Sciences,Wilfrid Laurier University,Waterloo.
Alana B
AB
Kirstein
2Rotman Research Institute of Baycrest,Mt. Sinai,Toronto,Ontario,Canada.
Morris
M
Freedman
2Rotman Research Institute of Baycrest,Mt. Sinai,Toronto,Ontario,Canada.
Nicolaas P L G
NP
Verhoeff
3Baycrest Department of Psychiatry,Mt. Sinai,Toronto,Ontario,Canada.
Uri
U
Wolf
2Rotman Research Institute of Baycrest,Mt. Sinai,Toronto,Ontario,Canada.
Tiffany W
TW
Chow
D000328:Adult; D000368:Aged; D003071:Cognition / Q000502:physiology; D003704:Dementia / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D000066553:Problem Behavior / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index
Alzheimer’s; apathy; behavioural and psychiatric symptoms of dementia; behavioural variant frontotemporal dementia; disease progression; disinhibition; duration of illness; longitudinal study; primary progressive aphasia