Title
Relation between frontal lobe symptoms and dementia severity within and across diagnostic dementia categories Relation between frontal lobe symptoms and dementia severity within and across diagnostic dementia categories
Author
Faculty/Department
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences . Biomedical Sciences
Publication type
article
Publication
Chichester ,
Subject
Human medicine
Source (journal)
International journal of geriatric psychiatry: a journal of the psychiatry of late life and allied sciences. - Chichester
Volume/pages
25(2010) :11 , p. 1186-1195
ISSN
0885-6230
ISI
000283765300012
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
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.
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