BACKGROUND: The six domain standard Clinical Dementia Rating Scale (CDRstd) has been successful for staging patients with the clinical syndrome of probable Alzheimer's disease (AD). The CDRstd does not specifically address language dysfunction or alteration in personality and social behaviors which are prominent in behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA). OBJECTIVE: To determine the value of adding domains of Language (LANG), and Behavior, Comportment, and Personality (BEHAV) to the CDRstd for the evaluation of patients with bvFTD and PPA. METHODS: Two new domains, LANG and BEHAV, were constructed to parallel the six domains sampled in the CDRstd. Clinical and neuropsychological test data were obtained from the National Alzheimer's Coordinating Center. The dataset contained information on 2550 probable AD, 88 vascular dementia, 281 dementia with Lewy body, 234 bvFTD, and 137 PPA patients. RESULTS: There were 76.5% of bvFTD and 99.3% of PPA patients with abnormal ratings (>0) on the LANG domain; 90.2% of bvFTD and 63.5% of PPA had abnormal ratings on the BEHAV domain. In patients with a CDRstd sum of boxes score of <4, 53.7% of bvFTD had BEHAV domain and 78.6% of PPA patients had LANG domain scores>1. Among probable AD patients, 3.7% had LANG ratings that were ≥1 and 3.8% had BEHAV ratings that were ≥1. Logistic regression analyses showed that adding either the LANG or BEHAV domains to the CDRstd sum of boxes score significantly improved the discrimination between probable AD, bvFTD, and PPA. CONCLUSIONS: The new LANG and BEHAV domains add value to the CDRstd for the characterization of the nonamnestic symptoms that are prominent in patients with bvFTD and PPA but that also occur in those with probable AD.
BACKGROUND: The six domain standard Clinical Dementia Rating Scale (CDRstd) has been successful for staging patients with the clinical syndrome of probable Alzheimer's disease (AD). The CDRstd does not specifically address language dysfunction or alteration in personality and social behaviors which are prominent in behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA). OBJECTIVE: To determine the value of adding domains of Language (LANG), and Behavior, Comportment, and Personality (BEHAV) to the CDRstd for the evaluation of patients with bvFTD and PPA. METHODS: Two new domains, LANG and BEHAV, were constructed to parallel the six domains sampled in the CDRstd. Clinical and neuropsychological test data were obtained from the National Alzheimer's Coordinating Center. The dataset contained information on 2550 probable AD, 88 vascular dementia, 281 dementia with Lewy body, 234 bvFTD, and 137 PPA patients. RESULTS: There were 76.5% of bvFTD and 99.3% of PPA patients with abnormal ratings (>0) on the LANG domain; 90.2% of bvFTD and 63.5% of PPA had abnormal ratings on the BEHAV domain. In patients with a CDRstd sum of boxes score of <4, 53.7% of bvFTD had BEHAV domain and 78.6% of PPA patients had LANG domain scores>1. Among probable ADpatients, 3.7% had LANG ratings that were ≥1 and 3.8% had BEHAV ratings that were ≥1. Logistic regression analyses showed that adding either the LANG or BEHAV domains to the CDRstd sum of boxes score significantly improved the discrimination between probable AD, bvFTD, and PPA. CONCLUSIONS: The new LANG and BEHAV domains add value to the CDRstd for the characterization of the nonamnestic symptoms that are prominent in patients with bvFTD and PPA but that also occur in those with probable AD.
Authors: D Sapolsky; A Bakkour; A Negreira; P Nalipinski; S Weintraub; M-M Mesulam; D Caplan; B C Dickerson Journal: Neurology Date: 2010-07-27 Impact factor: 9.910
Authors: D I Kaufer; J L Cummings; P Ketchel; V Smith; A MacMillan; T Shelley; O L Lopez; S T DeKosky Journal: J Neuropsychiatry Clin Neurosci Date: 2000 Impact factor: 2.198
Authors: G C Román; T K Tatemichi; T Erkinjuntti; J L Cummings; J C Masdeu; J H Garcia; L Amaducci; J M Orgogozo; A Brun; A Hofman Journal: Neurology Date: 1993-02 Impact factor: 9.910
Authors: Toji Miyagawa; Danielle Brushaber; Jeremy Syrjanen; Walter Kremers; Julie Fields; Leah K Forsberg; Hilary W Heuer; David Knopman; John Kornak; Adam Boxer; Howie Rosen; Bradley Boeve Journal: Alzheimers Dement Date: 2020-01-06 Impact factor: 21.566
Authors: Lucia A A Giannini; Sharon X Xie; Corey T McMillan; Mendy Liang; Andrew Williams; Charles Jester; Katya Rascovsky; David A Wolk; Sharon Ash; Edward B Lee; John Q Trojanowski; Murray Grossman; David J Irwin Journal: Ann Neurol Date: 2019-03-28 Impact factor: 10.422
Authors: Bradley Boeve; Jessica Bove; Patrick Brannelly; Danielle Brushaber; Giovanni Coppola; Rielly Dever; Christina Dheel; Bradford Dickerson; Susan Dickinson; Kelley Faber; Julie Fields; Jamie Fong; Tatiana Foroud; Leah Forsberg; Ralitza Gavrilova; Debra Gearhart; Nupur Ghoshal; Jennifer Goldman; Jonathan Graff-Radford; Neill Graff-Radford; Murray Grossman; Dana Haley; Hilary Heuer; Ging-Yuek Robin Hsiung; Edward Huey; David Irwin; David Jones; Lynne Jones; Kejal Kantarci; Anna Karydas; David Knopman; John Kornak; Ruth Kraft; Joel Kramer; Walter Kremers; Walter Kukull; Maria Lapid; Diane Lucente; Ian Mackenzie; Masood Manoochehri; Scott McGinnis; Bruce Miller; Rodney Pearlman; Len Petrucelli; Madeline Potter; Rosa Rademakers; Eliana Marisa Ramos; Kate Rankin; Katya Rascovsky; Pheth Sengdy; Les Shaw; Jeremy Syrjanen; Nadine Tatton; Joanne Taylor; Arthur Toga; John Trojanowski; Sandra Weintraub; Bonnie Wong; Zbigniew Wszolek; Adam Boxer; Howard Rosen Journal: Alzheimers Dement Date: 2020-01-06 Impact factor: 21.566
Authors: Hilary W Heuer; P Wang; K Rascovsky; A Wolf; B Appleby; J Bove; Y Bordelon; P Brannelly; D E Brushaber; C Caso; G Coppola; B Dickerson; S Dickinson; K Domoto-Reilly; K Faber; J Ferrall; J Fields; A Fishman; J Fong; T Foroud; L K Forsberg; D Gearhart; B Ghazanfari; N Ghoshal; J Goldman; J Graff-Radford; N Graff-Radford; I Grant; M Grossman; D Haley; G-Y Hsiung; E Huey; D Irwin; D Jones; K Kantarci; A Karydas; D Kaufer; D Kerwin; D Knopman; J Kornak; J H Kramer; R Kraft; W K Kremers; W Kukull; I Litvan; P Ljubenkov; I R Mackenzie; M Maldonado; M Manoochehri; S McGinnis; E McKinley; M F Mendez; B L Miller; C Onyike; A Pantelyat; R Pearlman; L Petrucelli; M Potter; R Rademakers; E M Ramos; K P Rankin; E D Roberson; E Rogalski; P Sengdy; L Shaw; J Syrjanen; M C Tartaglia; N Tatton; J Taylor; A Toga; J Trojanowski; S Weintraub; B Wong; Z Wszolek; B F Boeve; H J Rosen; A L Boxer Journal: Alzheimers Dement Date: 2020-01 Impact factor: 21.566
Authors: Deborah A Lowe; Steve Balsis; Tyler M Miller; Jared F Benge; Rachelle S Doody Journal: Dement Geriatr Cogn Disord Date: 2012 Impact factor: 2.959