Moheb Negar, Mendez Mario F, Kremen Sarah A, Teng Edmond
Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Dement Geriatr Cogn Disord. 2017;43(1-2):89-99. doi: 10.1159/000455119. Epub 2017 Jan 20.
Deficits in instrumental activities of daily living (ADLs) may be more prominent in behavioral variant frontotemporal dementia (bvFTD) than in nonfluent/agrammatic variant primary progressive aphasia (nfvPPA) or semantic variant primary progressive aphasia (svPPA). It is uncertain whether frontotemporal dementia (FTD) subgroups exhibit different patterns and/or predictors of functional impairment.
We examined data from participants diagnosed with bvFTD (n = 607), svPPA (n = 132), and nfvPPA (n = 155) who were included in the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) and assessed with the Functional Activities Questionnaire (FAQ). Stepwise multiple linear regression analyses were performed to identify associations between FAQ scores and cognitive/behavioral deficits using the NACC UDS neuropsychological testing battery and the Neuropsychiatric Inventory Questionnaire.
FAQ scores were higher in bvFTD than svPPA or nfvPPA. Functional deficits across FTD subtypes differed in severity, but not pattern, and were driven by executive dysfunction and behavioral symptoms.
Executive dysfunction and behavioral symptoms underlie instrumental ADL deficits in FTD, which are most prominent in bvFTD.
与非流利/语法缺失型原发性进行性失语(nfvPPA)或语义型原发性进行性失语(svPPA)相比,日常生活工具性活动(IADL)缺陷在行为变异型额颞叶痴呆(bvFTD)中可能更为突出。额颞叶痴呆(FTD)亚组是否表现出不同的功能损害模式和/或预测因素尚不确定。
我们检查了来自被诊断为bvFTD(n = 607)、svPPA(n = 132)和nfvPPA(n = 155)的参与者的数据,这些参与者被纳入了国家阿尔茨海默病协调中心(NACC)统一数据集(UDS),并使用功能活动问卷(FAQ)进行了评估。使用NACC UDS神经心理测试组合和神经精神科问卷进行逐步多元线性回归分析,以确定FAQ评分与认知/行为缺陷之间的关联。
bvFTD的FAQ评分高于svPPA或nfvPPA。FTD各亚型的功能缺陷在严重程度上有所不同,但模式相同,且由执行功能障碍和行为症状所致。
执行功能障碍和行为症状是FTD中IADL缺陷的基础,在bvFTD中最为突出。