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Comparisons of clinical symptoms in biomarker-confirmed Alzheimer's disease, dementia with Lewy bodies, and frontotemporal dementia patients in a local memory clinic.
Psychogeriatrics. 2015 Dec; 15(4):235-41.P

Abstract

BACKGROUND

There has been no previous Chinese study that differentiated the clinical symptoms among biomarker-confirmed Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD). The objective of this study was to compare the cognitive, behavioural, and neuropsychiatric symptoms in biomarker-confirmed AD, DLB, and FTD patients.

METHODS

We recruited 30 patients (14 AD, 7 DLB, 9 FTD) who presented to the memory clinic at Queen Mary Hospital from 1 January 2007 to 31 December 2013. AD was diagnosed according to the National Institution of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria with cerebrospinal fluid biomarkers (tau, phosphorylated tau, and amyloid β-42) fulfilling locally determined cut-off values for AD. DLB was diagnosed based on the McKeith diagnostic criteria. The behavioural variant of FTD was diagnosed based on the revised diagnostic criteria proposed by the International bvFTD Criteria Consortium, and language variant FTD was diagnosed based on the latest published criteria. In addition, patients with DLB and FTD had typical imaging features on single-photon emission computed tomography or (18) fludeoxyglucose-positron emission tomography, either with or without Pittsburgh Compound B imaging, which supported their diagnoses. Data on patient characteristics including demographics, presenting clinical features, Mini-Mental State Examination, clinical dementia ratings, and neuropsychiatry inventory scores were collected.

RESULTS

There were no differences in age, education level, dementia severity, and duration of symptoms before presentation among the three subgroups of patients. All patients had amnesia symptoms, which were not statistically significant. Apraxia was most common in AD. While 83% of the patients were affected by behavioural and neuropsychiatric symptoms of dementia, behavioural disinhibition and decline in executive function were most common in FTD patients. Recurrent hallucinations, fluctuation of consciousness, parkinsonism, and rapid eye movement sleep behaviour disorder were most common in DLB.

CONCLUSION

Memory impairment and apathy are not useful discriminative symptoms in diagnosing AD, DLB, and FTD. Apraxia favours AD. Hallucinations, particularly well-formed visual hallucinations, favour DLB. Overall, behavioural and neuropsychiatric symptoms of dementia symptoms are common among the three groups of dementia patients.

Authors+Show Affiliations

Divsion of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.Divsion of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.Divsion of Geriatrics, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong. The Alzheimer's Disease Research Network, SRT Aging, The University of Hong Kong, Hong Kong.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25533477

Citation

Shea, Yat Fung, et al. "Comparisons of Clinical Symptoms in Biomarker-confirmed Alzheimer's Disease, Dementia With Lewy Bodies, and Frontotemporal Dementia Patients in a Local Memory Clinic." Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society, vol. 15, no. 4, 2015, pp. 235-41.
Shea YF, Ha J, Chu LW. Comparisons of clinical symptoms in biomarker-confirmed Alzheimer's disease, dementia with Lewy bodies, and frontotemporal dementia patients in a local memory clinic. Psychogeriatrics. 2015;15(4):235-41.
Shea, Y. F., Ha, J., & Chu, L. W. (2015). Comparisons of clinical symptoms in biomarker-confirmed Alzheimer's disease, dementia with Lewy bodies, and frontotemporal dementia patients in a local memory clinic. Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society, 15(4), 235-41. https://doi.org/10.1111/psyg.12103
Shea YF, Ha J, Chu LW. Comparisons of Clinical Symptoms in Biomarker-confirmed Alzheimer's Disease, Dementia With Lewy Bodies, and Frontotemporal Dementia Patients in a Local Memory Clinic. Psychogeriatrics. 2015;15(4):235-41. PubMed PMID: 25533477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparisons of clinical symptoms in biomarker-confirmed Alzheimer's disease, dementia with Lewy bodies, and frontotemporal dementia patients in a local memory clinic. AU - Shea,Yat Fung, AU - Ha,Joyce, AU - Chu,Leung-Wing, Y1 - 2014/12/23/ PY - 2014/08/25/received PY - 2014/10/07/revised PY - 2014/11/25/accepted PY - 2014/12/24/entrez PY - 2014/12/24/pubmed PY - 2016/5/27/medline KW - Alzheimer's disease KW - Lewy body disease KW - biomarker KW - frontotemporal dementia SP - 235 EP - 41 JF - Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society JO - Psychogeriatrics VL - 15 IS - 4 N2 - BACKGROUND: There has been no previous Chinese study that differentiated the clinical symptoms among biomarker-confirmed Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD). The objective of this study was to compare the cognitive, behavioural, and neuropsychiatric symptoms in biomarker-confirmed AD, DLB, and FTD patients. METHODS: We recruited 30 patients (14 AD, 7 DLB, 9 FTD) who presented to the memory clinic at Queen Mary Hospital from 1 January 2007 to 31 December 2013. AD was diagnosed according to the National Institution of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria with cerebrospinal fluid biomarkers (tau, phosphorylated tau, and amyloid β-42) fulfilling locally determined cut-off values for AD. DLB was diagnosed based on the McKeith diagnostic criteria. The behavioural variant of FTD was diagnosed based on the revised diagnostic criteria proposed by the International bvFTD Criteria Consortium, and language variant FTD was diagnosed based on the latest published criteria. In addition, patients with DLB and FTD had typical imaging features on single-photon emission computed tomography or (18) fludeoxyglucose-positron emission tomography, either with or without Pittsburgh Compound B imaging, which supported their diagnoses. Data on patient characteristics including demographics, presenting clinical features, Mini-Mental State Examination, clinical dementia ratings, and neuropsychiatry inventory scores were collected. RESULTS: There were no differences in age, education level, dementia severity, and duration of symptoms before presentation among the three subgroups of patients. All patients had amnesia symptoms, which were not statistically significant. Apraxia was most common in AD. While 83% of the patients were affected by behavioural and neuropsychiatric symptoms of dementia, behavioural disinhibition and decline in executive function were most common in FTD patients. Recurrent hallucinations, fluctuation of consciousness, parkinsonism, and rapid eye movement sleep behaviour disorder were most common in DLB. CONCLUSION: Memory impairment and apathy are not useful discriminative symptoms in diagnosing AD, DLB, and FTD. Apraxia favours AD. Hallucinations, particularly well-formed visual hallucinations, favour DLB. Overall, behavioural and neuropsychiatric symptoms of dementia symptoms are common among the three groups of dementia patients. SN - 1479-8301 UR - https://www.unboundmedicine.com/medline/citation/25533477/Comparisons_of_clinical_symptoms_in_biomarker_confirmed_Alzheimer's_disease_dementia_with_Lewy_bodies_and_frontotemporal_dementia_patients_in_a_local_memory_clinic_ L2 - https://doi.org/10.1111/psyg.12103 DB - PRIME DP - Unbound Medicine ER -