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Functionality and cognitive performance of patients with behavioral variant Frontotemporal Dementia

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Author(s):
Thais Bento Lima Silva
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
Defense date:
Examining board members:
Monica Sanches Yassuda; Benito Pereira Damasceno; Leticia Lessa Mansur
Advisor: Monica Sanches Yassuda
Abstract

Summary Introduction: There are but a few research studies on functional impairment in behavioral variant Frontotemporal Dementia. Less studied dementia subtypes, such as bvFTD, have been gaining prominence due to their epidemiological significance. The objectives of the present research were to: 1. Characterize the functional and cognitive performance of patients previously diagnosed with bvFTD treated at outpatient clinics of Neurology and Psychiatry, and compare their performance with that of patients with AD and normal controls; 2. Examine the correlation between performance in the functional scales (DAFS-BR, DAD e PFAQ) and cognitive performance; and 3. Evaluate the diagnostic accuracy of the DAFS-BR for detecting bvFTD and AD. Methodology: The sample consisted of 96 individuals aged 45 or older, with at least two years of formal education. Of these, 31 had been diagnosed with bvFTD, 31 with AD, and 34 were healthy adults paired with the patients with bvFTD and AD for age and education. The following instruments were used: sociodemographic and clinical questionnaire; 15-item Geriatric Depression Scale (GDS); Geriatric Anxiety Inventory (GAI); Addenbrooke Cognitive Examination-Revised (ACE-R), which includes the questions of the Mini Mental State Examination (MMSE); Executive Interview (EXIT-25); and the Direct Assessment of Functional Status Revised (DAFS-BR). The protocol for caregivers included the Cornell Scale for Depression in Dementia, Pfeffer Functional Activities Questionnaire (PFAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI) and the Clinical Dementia Rating scale (CDR). Results: Individuals in the bvFTD group had lower performance in the ´Eating skills´ item of the DAFS-BR, and in ´Initiation´ and in ´Planning/Organization´ in the DAD, suggesting a higher level of dependence in bvFTD, and Higher scores in the PFAQ suggested that dependence in bvFTD is more pronounced. Significant correlations were found between cognitive and functional performances. The accuracy data for the DAFS-BR indicated that the scale can help identify dementia however, it has limitations in the differential diagnosis among subtypes. Final Considerations: The results suggest that individuals with bvFTD display greater functional impairment when compared to individuals with AD and to healthy adults. These results highlight the importance of assessing functionality status among patients suspected to have bvFTD. These deficits are relevant for the diagnosis and clinical management of this subtype of dementia. (AU)

FAPESP's process: 11/04804-1 - Functionality and cognitive performance in frontotemporal dementia
Grantee:Thaís Bento Lima da Silva
Support Opportunities: Scholarships in Brazil - Master