Departments of *Biostatistics and Epidemiology ‡Neurology, Perelman School of Medicine, University of Pennsylvania †Department of Neurology, Drexel University College of Medicine, Philadelphia, PA.
Alzheimer Dis Assoc Disord. 2013 Oct-Dec;27(4):310-5. doi: 10.1097/WAD.0b013e31827bdc6f.
To examine how phenotype affects longitudinal decline on the Mini-Mental State Examination (MMSE) in patients with frontotemporal lobar degeneration (FTLD) and Alzheimer disease (AD).
The MMSE is the most commonly administered assessment for dementia severity; however, the effects of phenotype on longitudinal MMSE performance in FTLD and AD have not been extensively studied.
Data from 185 patients diagnosed with AD (n=106) and 3 FTLD (n=79) phenotypes [behavioral variant frontotemporal dementia (bvFTD), nonfluent agrammatic variant of primary progressive aphasia (nfaPPA), and semantic variant PPA (svPPA)] were collected for up to 52 months since initial evaluation.
Differential rates of decline were noted in that MMSE scores declined more precipitously for AD and svPPA compared with bvFTD and nfaPPA patients (P=0.001). The absolute 4-year MMSE decline given median baseline MMSE for bvFTD [14.67; 95% confidence interval (CI), 14.63-14.71] and nfaPPA (11.02; 95% CI, 10.98-11.06) were lower than svPPA (22.32; 95% CI, 22.29-22.34) or AD (22.24; 95% CI, 22.22-22.26).
These data suggest that within-group AD and FTLD phenotypes present distinct patterns of longitudinal decline on the MMSE. MMSE may not be adequately sensitive to track disease progression in some phenotypes of FTLD.
探讨额颞叶变性（FTLD）和阿尔茨海默病（AD）患者的表型如何影响简易精神状态检查（MMSE）的纵向衰退。
MMSE 是评估痴呆严重程度最常用的方法；然而，表型对 FTLD 和 AD 患者纵向 MMSE 表现的影响尚未得到广泛研究。
收集了 185 名 AD（n=106）和 3 种 FTLD （bvFTD、非流利性语法障碍型原发性进行性失语症（nfaPPA）和语义性进行性失语症（svPPA））患者的数据，自初始评估以来最长随访 52 个月。
研究发现，AD 和 svPPA 患者的 MMSE 评分下降速度明显快于 bvFTD 和 nfaPPA 患者（P=0.001）。考虑到基线 MMSE 的中位数，bvFTD （14.67；95%置信区间[CI]，14.63-14.71）和 nfaPPA （11.02；95% CI，10.98-11.06）患者的 4 年 MMSE 绝对下降值低于 svPPA（22.32；95% CI，22.29-22.34）或 AD（22.24；95% CI，22.22-22.26）。
这些数据表明，AD 和 FTLD 表型在 MMSE 上的纵向衰退模式存在差异。在某些 FTLD 表型中，MMSE 可能不够敏感，无法跟踪疾病进展。
