Borroni Barbara, Alberici Antonella, Agosti Chiara, Premi Enrico, Padovani Alessandro
Department of Neurology, University of Brescia, Italy.
Int J Geriatr Psychiatry. 2008 Aug;23(8):796-800. doi: 10.1002/gps.1974.
The role of modifiable and non-modifiable variables in Frontotemporal Dementia (FTD) as compared to Alzheimer's dDisease (AD) and to Progressive Supranuclear Palsy (PSP) or Corticobasal Degeneration Syndrome (CBDS) has not been extensively evaluated. In particular, low education levels have been reported to be a risk factor for AD, but their contribution in FTD is yet not known.
To investigate the role of education, other modifiable and non-modifiable factors in FTD as compared to AD, PSP and CBDS patients.
One hundred and seventeen FTD patients, 400 AD, 55 PSP, and 55 CBDS entered the study. Demographic and clinical characteristics were carefully recorded. Age, gender, family history for dementia and Apolipoprotein E (APOE) genotype were considered as non-modifiable factors; education and comorbidities were included as modifiable variables. Regression analyses were applied in order to identify differences among groups.
FTD differed from AD patients in terms of younger age, positive family history and gender status. In regard to APOE genotype, no differences between FTD and AD were found, but FTD showed higher prevalence of epsilon 4 allele compared to both CBDS and PSP patients (p < 0.05). When modifiable factors were considered, FTD were higher educated than AD patients (p < 0.001). Regression analysis identified younger age, positive family history, and education levels as independently associated variables to FTD diagnosis compared to AD (F = 21.27, R(2) = 24.1, p = 0.036).
Our results highlight that the contribution of education and non-modifiable factors is likely different in FTD and AD. Further work is needed to completely establish the role of this modifiable variable as a potential area of intervention for dementias.
与阿尔茨海默病（AD）、进行性核上性麻痹（PSP）或皮质基底节变性综合征（CBDS）相比，可改变和不可改变变量在额颞叶痴呆（FTD）中的作用尚未得到广泛评估。特别是，低教育水平已被报道为AD的一个危险因素，但其在FTD中的作用尚不清楚。
研究与AD、PSP和CBDS患者相比，教育、其他可改变和不可改变因素在FTD中的作用。
117例FTD患者、400例AD患者、55例PSP患者和55例CBDS患者进入本研究。仔细记录人口统计学和临床特征。年龄、性别、痴呆家族史和载脂蛋白E（APOE）基因型被视为不可改变因素；教育程度和合并症被作为可改变变量纳入。应用回归分析以确定组间差异。
FTD与AD患者在年龄较轻、家族史阳性和性别状况方面存在差异。关于APOE基因型，FTD与AD之间未发现差异，但与CBDS和PSP患者相比，FTD中ε4等位基因的患病率更高（p<0.05）。当考虑可改变因素时，FTD患者的教育程度高于AD患者（p<0.001）。回归分析确定，与AD相比（F=21.27，R(2)=24.1，p=0.036），年龄较轻、家族史阳性和教育程度是与FTD诊断独立相关的变量。
我们的结果表明，教育和不可改变因素在FTD和AD中的作用可能不同。需要进一步开展工作，以完全确定这个可改变变量作为痴呆潜在干预领域的作用。
