Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-29T01:13:19.309Z Has data issue: false hasContentIssue false
  • English
  • Français

Frontotemporal dementia and dementia with Lewy bodies in a case-control study of Alzheimer's disease

Published online by Cambridge University Press:  01 August 2009

Olivier Piguet ,
Glenda M. Halliday ,
Helen Creasey ,
G. Anthony Broe  and
Jillian J. Kril
Olivier Piguet*
Affiliation:
Prince of Wales Medical Research Institute and University of New South Wales, Sydney, Australia
Glenda M. Halliday
Affiliation:
Prince of Wales Medical Research Institute and University of New South Wales, Sydney, Australia
Helen Creasey
Affiliation:
Centre for Education and Research on Ageing and University of Sydney, Sydney, Australia
G. Anthony Broe
Affiliation:
Prince of Wales Medical Research Institute and University of New South Wales, Sydney, Australia Prince of Wales Hospital, Randwick, Sydney, Australia
Jillian J. Kril
Affiliation:
Disciplines of Medicine and Pathology, University of Sydney, Sydney, Australia
*
Correspondence should be addressed to: Olivier Piguet, Prince of Wales Medical Research Institute, Barker St, Randwick NSW 2031, Australia. Phone: +61 2 9399 1113; Fax: +61 2 9399 1047. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The clinical presentations in dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD) overlap considerably with that of Alzheimer's disease (AD) despite different pathological processes. Autopsy studies have also shown that multiple brain pathology occurs frequently, even in cases with a single clinical diagnosis. We aimed to determine the frequency of clinical diagnosis of FTD and DLB and the underlying pathology in a well-characterized cohort of patients with a clinical diagnosis of probable or possible AD.

Methods: We conducted a retrospective analysis of 170 AD patients (probable AD = 83; possible AD = 87) originally enrolled in a case-control study, 27 with postmortem examination, to establish the number of cases meeting probable diagnosis for FTD and DLB, using a checklist of features compiled from their consensus criteria.

Results: 23/83 probable AD cases and 32/87 possible AD cases met probable criteria for another dementia, more commonly DLB than FTD. AD pathology was present in 8/15 probable AD and 8/12 possible AD cases coming to autopsy. DLB pathology was seen in four cases and FTD pathology in eight cases. In the AD cases reaching clinical diagnosis for a second dementia syndrome and coming to autopsy, a minority showed non-AD pathology only.

Conclusions: Presence of core clinical features of non-AD dementia syndromes is common in AD. Concordance between clinical and pathological diagnoses of dementia remains variable. We propose that repeat clinical examinations and structural neuroimaging will improve diagnostic accuracy. In addition, clinical diagnostic criteria for the main dementia syndromes require refinement.

Keywords

ADdiagnostic criteriaDLBFTDneuropathology
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 4 , August 2009 , pp. 688 - 695
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amador-Ortiz, C. et al. (2007). TDP-43 immunoreactivity in hippocampal sclerosis and Alzheimer's disease. Annals of Neurology, 61, 435–445.CrossRefGoogle ScholarPubMed
Braak, H. and Braak, E. (1996). Evolution of neuropathology of Alzheimer's disease. Acta Neurologica Scandinavia, Supplement 165, 3–12.CrossRefGoogle ScholarPubMed
Broe, G. A. et al. (1990). A case-control study of Alzheimer's disease in Australia. Neurology, 40, 1698–1707.CrossRefGoogle ScholarPubMed
Cairns, N. J. et al. (2007). Neuropathologic diagnostic and nosologic criteria for frontotemporal lobar degeneration: consensus of the Consortium for Frontotemporal Lobar Degeneration. Acta Neuropathologica (Berlin), 114, 5–22.CrossRefGoogle Scholar
Dubois, B. et al. (2007). Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurology, 6, 734–746.CrossRefGoogle ScholarPubMed
Funkenstein, H. H. et al. (1993). Extrapyramidal signs and other neurologic findings in clinically diagnosed Alzheimer's disease: a community-based study. Archives of Neurology, 50, 51–56.CrossRefGoogle ScholarPubMed
Graham, A. et al. (2005). Pathologically proven frontotemporal dementia presenting with severe amnesia. Brain, 128, 597–605.CrossRefGoogle ScholarPubMed
Halliday, G. et al. (2002). Consensus neuropathological diagnosis of common dementia syndromes: testing and standardising Australian practice. Acta Neuropathologica, 104, 72–78.CrossRefGoogle Scholar
Harding, A. J. and Halliday, G. M. (1998). Simplified neuropathological diagnosis of dementia with Lewy bodies. Neuropathology and Applied Neurobiology, 24, 195–201.CrossRefGoogle ScholarPubMed
Henderson, A. S. et al. (1992). Environmental risk factors for Alzheimer's disease: their relationship to age of onset and to familial or sporadic types. Psychological Medicine, 22, 429–436.CrossRefGoogle ScholarPubMed
Hohl, U., Tiraboschi, P., Hansen, L. A., Thal, L. J. and Corey-Bloom, J. (2000). Diagnostic accuracy of dementia with Lewy bodies. Archives of Neurology, 57, 347–351.CrossRefGoogle ScholarPubMed
Kril, J. J., Macdonald, V., Patel, S., Png, F. and Halliday, G. M. (2005). Distribution of brain atrophy in behavioral variant frontotemporal dementia. Journal of the Neurological Sciences, 232, 83–90.CrossRefGoogle ScholarPubMed
Lim, A. et al. (1999). Clinico-neuropathological correlation of Alzheimer's disease in a community-based case series. Journal of the American Geriatrics Society, 47, 564–569.CrossRefGoogle Scholar
Londos, E., Passant, U., Gustafson, L. and Brun, A. (2001). Neuropathological correlates to clinically defined dementia with Lewy bodies. International Journal of Geriatric Psychiatry, 16, 667–679.CrossRefGoogle ScholarPubMed
Lopez, O. L. et al. (2002). Research evaluation and prospective diagnosis of dementia with Lewy bodies. Archives of Neurology, 59, 43–46.CrossRefGoogle ScholarPubMed
McKeith, I. G. et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 1113–1124.CrossRefGoogle Scholar
McKeith, I. G., Perry, E. K. and Perry, R. H. (1999). Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Consortium on Dementia with Lewy Bodies. Neurology, 53, 902–905.CrossRefGoogle Scholar
McKeith, I. G. et al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 65, 1863–1872.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services task force on Alzheimer's disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
McKhann, G. M., Albert, M. S., Grossman, M., Miller, B., Dickson, D. and Trojanowski, J. Q. (2001). Clinical and pathological diagnosis of frontotemporal dementia: report of the Work Group on Frontotemporal Dementia and Pick's Disease. Archives of Neurology, 58, 1803–1809.CrossRefGoogle Scholar
Mendez, M. F., Cherrier, M., Perryman, K. M., Pachana, N., Miller, B. L. and Cummings, J. L. (1996). Frontotemporal dementia versus Alzheimer's disease: differential cognitive features. Neurology, 47, 1189–1194.CrossRefGoogle ScholarPubMed
Mirra, S. S. et al. (1991). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer's disease. Neurology, 41, 479–486.CrossRefGoogle Scholar
National Institute on Aging and Reagan Institute (1997). Consensus recommendations for the postmortem diagnosis of Alzheimer's disease. The National Institute on Aging, and Reagan Institute Working Group on Diagnostic Criteria for the Neuropathological Assessment of Alzheimer's Disease. Neurobiology of Aging, 18, S1–2.Google Scholar
Neary, D. et al. (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 1546–1554.CrossRefGoogle ScholarPubMed
Piguet, O., Hornberger, M., Shelley, B. P., Kipps, C. M. and Hodges, J. R. (2009). Sensitivity of current criteria for the diagnosis of behavioral variant frontotemporal dementia. Neurology, 72, 732–737.CrossRefGoogle ScholarPubMed
Ratnavalli, E., Brayne, C., Dawson, K. and Hodges, J. R. (2002). The prevalence of frontotemporal dementia. Neurology, 58, 1615–1621.CrossRefGoogle ScholarPubMed
Román, G. C. et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250–260.CrossRefGoogle ScholarPubMed
Rosen, H. J. et al. (2002). Utility of clinical criteria in differentiating frontotemporal lobar degeneration (FTLD) from AD. Neurology, 58, 1608–1615.CrossRefGoogle ScholarPubMed
Shepherd, C. E. et al. (2004). Positional effects of presenilin-1 mutations on tau phosphorylation in cortical plaques. Neurobiology of Disease, 15, 115–119.CrossRefGoogle ScholarPubMed
Stevens, T., Livingston, G., Kitchen, G., Manela, M., Walker, Z. and Katona, C. (2002). Islington study of dementia subtypes in the community. British Journal of Psychiatry, 180, 270–276.CrossRefGoogle ScholarPubMed