Longitudinal changes in functional capacity in frontotemporal dementia and Alzheimer's disease.

IF 4 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2024-11-15 eCollection Date: 2024-10-01 DOI:10.1002/dad2.70028

David Foxe, Muireann Irish, Sau Chi Cheung, Mirelle D'Mello, Yun Tae Hwang, James Muggleton, Nicholas J Cordato, Olivier Piguet

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Abstract

Introduction: This study investigated the changes in functional capacity with disease progression in a well-characterised cohort of patients diagnosed with frontotemporal dementia (FTD) and Alzheimer's disease (AD) presentations.

Methods: We recruited 126 behavioural variant FTD (bvFTD), 40 progressive nonfluent aphasia (PNFA), 64 semantic dementia (SD), 45 logopenic progressive aphasia (LPA), and 115 AD patients. Functional capacity was measured annually over ∼7 years using the Disability Assessment for Dementia.

Results: Linear mixed effects models revealed the bvFTD group demonstrated disproportionate functional impairment at baseline and over the study period. Functional capacity among the other syndromes showed a more uniform pattern of decline, with less severe functional impairment at baseline and ∼7%-10% mean annual decline. Baseline correlations indicated different mechanisms supporting basic and complex functional proficiency among the groups.

Discussion: Our findings demonstrate distinct functional profiles across dementia syndromes with disease progression. Identifying progression milestones across syndromes will improve clinical management.

Highlights: bvFTD shows severe functional impairment at baseline and over time.PNFA, SD, LPA, AD: less severe baseline functional impairment; more uniform decline.General cognition is related to IADLs, but not BADLs, in all groups.Behavioural disturbances relate to IADLs and BADLs in bvFTD and SD.Behavioural-ADL relations are more mixed in PNFA, LPA, and AD.

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额颞叶痴呆症和阿尔茨海默氏症患者功能能力的纵向变化。

简介本研究调查了一组特征明确的额颞叶痴呆（FTD）和阿尔茨海默病（AD）患者的功能随着疾病进展的变化情况：我们招募了126名行为变异型FTD（bvFTD）患者、40名进行性非流利性失语症（PNFA）患者、64名语义痴呆症（SD）患者、45名对数开放性进行性失语症（LPA）患者和115名AD患者。在7年多的时间里，每年使用痴呆症残疾评估方法对患者的功能能力进行测量：结果：线性混合效应模型显示，bvFTD 组在基线和研究期间的功能损害不成比例。其他综合征的功能能力下降模式较为一致，基线时的功能损伤程度较轻，平均每年下降7%-10%。基线相关性表明，支持各组基本和复杂功能熟练程度的机制不同：讨论：我们的研究结果表明，随着疾病的进展，不同痴呆综合征的功能特征各不相同。重点：bvFTD在基线和随着时间的推移显示出严重的功能障碍。PNFA、SD、LPA、AD：基线功能障碍不太严重；下降更均匀。在所有组别中，一般认知与IADLs有关，但与BADLs无关。在bvFTD和SD中，行为障碍与IADLs和BADLs有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.