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23 April 2009

Aggressive and impulsive behaviors in Frontotemporal dementia and Alzheimer's disease

Bozena Grochmal-BachABDEF, Leszek BidzanABCDEF, Maria PachalskaABCDEF, Mariola BidzanABCF, Beata LukaszewskaABCF, Anna PufalBCF

Med Sci Monit 2009; 15(5): CR248-254 :: ID: 869647

Abstract

Background
Differentiating FTD and AD is of great clinical significance, due to the very different efficacy of cholinesterase inhibitors in the two disorders. Previous studies have pointed to behavioral differences in FTD and AD, but less attention has been paid to comparing aggressive and impulsive behaviors in the AD and the FTD.
Material and Method
Nursing home residents diagnosed with AD (NINCDS/ADRDA criteria) or the behavioral variant of FTD (Frontotemporal Dementia and Pick's Disease Working Group criteria) were included in the research group. Individuals diagnosed with AD who showed atrophy of the frontal lobes in neuroimaging were excluded from the study, as were patients matching the clinical criteria for bvFTD, but with lesions in the temporal lobes. Agitation and aggressive behaviors were assessed using the Cohen-Mansfield Agitation Inventory (CMAI), whereas behavioral and psychological symptoms were assessed with the Neuropsychiatric Inventory - Nursing Home Version (NPI-NH).
Results
The overall NPI-NH score, including with some partial scores (apathy/indifference and disinhibition), together with the intensity of aberrant motor behavior differentiated individuals with AD from those with bvFTD. On the CMAI scale, both the overall score and physical aggressive behaviors differentiated the two study groups.
Conclusions
Our research confirms previous results indicating a greater intensity of behavioral pathology in FTD. A detailed assessment of aggressive behaviors revealed further differences between AD and FTD in this respect.

Keywords: Mental Disorders - etiology, Dementia - complications, Alzheimer Disease - complications

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