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). CONCLUSION: 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.
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). CONCLUSION: 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: Adam L Boxer; Michael Gold; Edward Huey; William T Hu; Howard Rosen; Joel Kramer; Fen-Biao Gao; Edward A Burton; Tiffany Chow; Aimee Kao; Blair R Leavitt; Bruce Lamb; Megan Grether; David Knopman; Nigel J Cairns; Ian R Mackenzie; Laura Mitic; Erik D Roberson; Daniel Van Kammen; Marc Cantillon; Kathleen Zahs; George Jackson; Stephen Salloway; John Morris; Gary Tong; Howard Feldman; Howard Fillit; Susan Dickinson; Zaven S Khachaturian; Margaret Sutherland; Susan Abushakra; Joseph Lewcock; Robert Farese; Robert O Kenet; Frank Laferla; Steve Perrin; Steve Whitaker; Lawrence Honig; Marsel M Mesulam; Brad Boeve; Murray Grossman; Bruce L Miller; Jeffrey L Cummings Journal: Alzheimers Dement Date: 2012-10-10 Impact factor: 21.566
Authors: Angela G Brega; Ann Reynolds; Rachael E Bennett; Maureen A Leehey; Lanee S Bounds; Jennifer B Cogswell; Randi J Hagerman; Paul J Hagerman; Jim Grigsby Journal: Int J Geriatr Psychiatry Date: 2009-10 Impact factor: 3.485