Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network.
Dementia
Epidemiology
Frontotemporal dementia
Progression
Journal
Alzheimer's research & therapy
ISSN: 1758-9193
Titre abrégé: Alzheimers Res Ther
Pays: England
ID NLM: 101511643
Informations de publication
Date de publication:
08 01 2021
08 01 2021
Historique:
received:
29
07
2020
accepted:
16
12
2020
entrez:
9
1
2021
pubmed:
10
1
2021
medline:
25
6
2021
Statut:
epublish
Résumé
Due to heterogeneous clinical presentation, difficult differential diagnosis with Alzheimer's disease (AD) and psychiatric disorders, and evolving clinical criteria, the epidemiology and natural history of frontotemporal lobar degeneration (FTD) remain elusive. In order to better characterize FTD patients, we relied on the database of a regional memory clinic network with standardized diagnostic procedures and chose AD patients as a comparator. Patients that were first referred to our network between January 2010 and December 2016 and whose last clinical diagnosis was degenerative or vascular dementia were included. Comparisons were conducted between FTD and AD as well as between the different FTD syndromes, divided into language variants (lvFTD), behavioral variant (bvFTD), and FTD with primarily motor symptoms (mFTD). Cognitive progression was estimated with the yearly decline in Mini Mental State Examination (MMSE). Among the patients that were referred to our network in the 6-year time span, 690 were ultimately diagnosed with FTD and 18,831 with AD. Patients with FTD syndromes represented 2.6% of all-cause dementias. The age-standardized incidence was 2.90 per 100,000 person-year and incidence peaked between 75 and 79 years. Compared to AD, patients with FTD syndromes had a longer referral delay and delay to diagnosis. Patients with FTD syndromes had a higher MMSE score than AD at first referral while their progression was similar. mFTD patients had the shortest survival while survival in bvFTD, lvFTD, and AD did not significantly differ. FTD patients, especially those with the behavioral variant, received more antidepressants, anxiolytics, and antipsychotics than AD patients. FTD syndromes differ with AD in characteristics at baseline, progression rate, and treatment. Despite a broad use of the new diagnostic criteria in an organized memory clinic network, FTD syndromes are longer to diagnose and account for a low proportion of dementia cases, suggesting persistent underdiagnosis. Congruent with recent publications, the late peak of incidence warns against considering FTD as being exclusively a young-onset dementia.
Sections du résumé
BACKGROUND
Due to heterogeneous clinical presentation, difficult differential diagnosis with Alzheimer's disease (AD) and psychiatric disorders, and evolving clinical criteria, the epidemiology and natural history of frontotemporal lobar degeneration (FTD) remain elusive. In order to better characterize FTD patients, we relied on the database of a regional memory clinic network with standardized diagnostic procedures and chose AD patients as a comparator.
METHODS
Patients that were first referred to our network between January 2010 and December 2016 and whose last clinical diagnosis was degenerative or vascular dementia were included. Comparisons were conducted between FTD and AD as well as between the different FTD syndromes, divided into language variants (lvFTD), behavioral variant (bvFTD), and FTD with primarily motor symptoms (mFTD). Cognitive progression was estimated with the yearly decline in Mini Mental State Examination (MMSE).
RESULTS
Among the patients that were referred to our network in the 6-year time span, 690 were ultimately diagnosed with FTD and 18,831 with AD. Patients with FTD syndromes represented 2.6% of all-cause dementias. The age-standardized incidence was 2.90 per 100,000 person-year and incidence peaked between 75 and 79 years. Compared to AD, patients with FTD syndromes had a longer referral delay and delay to diagnosis. Patients with FTD syndromes had a higher MMSE score than AD at first referral while their progression was similar. mFTD patients had the shortest survival while survival in bvFTD, lvFTD, and AD did not significantly differ. FTD patients, especially those with the behavioral variant, received more antidepressants, anxiolytics, and antipsychotics than AD patients.
CONCLUSIONS
FTD syndromes differ with AD in characteristics at baseline, progression rate, and treatment. Despite a broad use of the new diagnostic criteria in an organized memory clinic network, FTD syndromes are longer to diagnose and account for a low proportion of dementia cases, suggesting persistent underdiagnosis. Congruent with recent publications, the late peak of incidence warns against considering FTD as being exclusively a young-onset dementia.
Identifiants
pubmed: 33419472
doi: 10.1186/s13195-020-00753-9
pii: 10.1186/s13195-020-00753-9
pmc: PMC7796569
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
19Investigateurs
Rachid Abied
(R)
Cathrine Adnet
(C)
Arnaud Barois
(A)
Stéphanie Baude
(S)
Véronique Berriot
(V)
Stéphanie Bombois
(S)
Gloria Boyer
(G)
Didier Brique
(D)
Gauthier Calais
(G)
Pascaline Cassagnaud
(P)
Hacène Drchekroud
(H)
Yaohua Chen
(Y)
Joel Cliche
(J)
Charlotte Crinquette
(C)
Valérie Dachy
(V)
Valerie Debock
(V)
Anne Deprez
(A)
Vincent Deramecourt
(V)
Olivier Dereeper
(O)
Philippe Devos
(P)
Abdelghani Elazouzi
(A)
Adeline Enderle
(A)
Nicolas Fanjaud
(N)
Pierre Forzy
(P)
Karim Gallouj
(K)
Karine Garcon
(K)
Marie Honore
(M)
Dominique Huvent
(D)
Houria Idiri
(H)
Annabelle Ladeiro
(A)
Isabelle Lavenu
(I)
Florence Lebert
(F)
Thibaud Lebouvier
(T)
Patrick Le Coz
(P)
Eugénie Leclercq
(E)
Denis Lefebvre
(D)
Pierre Maciejasz
(P)
Marie-Anne Mackowiak
(MA)
Rémi Messin
(R)
Florence Pasquier
(F)
Valérie Petit
(V)
Christine Plichon
(C)
Sandrine Ponthieu
(S)
Cécile Quievre
(C)
Jean Roche
(J)
Adeline Rollin Sillaire
(A)
Thierry Rosolacci
(T)
Olivier Senechal
(O)
Nathalie Taillez
(N)
Stéphanie Thibault Tanchou
(S)
Frédéric Tison
(F)
Sarah Tollot
(S)
Marie Trocmet
(M)
Charlotte Verpoort
(C)
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