This study evaluated the diagnostic utility of a theoretically-driven bedside neuropsychological screening battery in differentiating between frontal variant frontotemporal dementia (fvFTD) and Alzheimer's disease (AD). Twenty-six FvFTD participants and 26 AD participants matched on the Clinical Dementia Rating scale (CDR) and education level, and 26 education-matched healthy controls (HC) were compared on five measures of a neuropsychological screening battery used at the UCSF Memory and Aging Center. Cognitive domains assessed were verbal and visual delayed recall, letter and category fluency, working memory and set-shifting. Dependent variables included percent retention on both the Short Form of the California Verbal Learning Test-Second Edition (CVLT-PR) and the Modified Rey-Osterreith Complex Figure Test (Rey-PR), words generated on letter (D-Words) and category (Animals) fluency tasks, and errors committed on the Modified Trail Making Test (M-Trails).
Healthy control participants outperformed the AD participants on the CVLT-PR, Rey-PR, Animals, and M-Trails. However, the groups did not differ on D-Words. Healthy control participants outperformed the fvFTD participants on the Rey-PR, Animals, D-Words, and M-Trails, but the two groups did not differ significantly on the CVLT-PR. FvFTD participants had a significantly higher percent retention compared to AD participants on both delayed recall tasks. The AD and fvFTD participants did not differ on D-Words, Animals, or M-Trails. However, measures designed to characterize differing patterns of performance on fluency tasks, the Fluency Difference Score (score on Animals − score on D-Words), and the Rascovsky Semantic Index (ratio of Animals over D-words + Animals), discriminated significantly between the AD and FTD participants (p < .001). </p>
Hierarchical multinomial and binomial logistic regression analyses were performed to determine which variables were the best predictors of diagnostic category, as well as the additive value of the neuropsychological variables after controlling for the influence of MMSE and age. A multinomial model including the CVLT-PR, M-Trails, Fluency Difference Score, age, and MMSE, accurately predicted 90% of the cases. Although cross-validation is necessary, these results support the diagnostic utility of a theoretically-driven bedside screening battery tapping cognitive constructs known to be differentially affected in AD and FTD.
|Advisor:||Wisniewski, Amy M.|
|Commitee:||Lovett, Steven, Moses, James A.|
|School:||Palo Alto University|
|School Location:||United States -- California|
|Source:||DAI-B 72/07, Dissertation Abstracts International|
|Subjects:||Neurosciences, Aging, Clinical psychology|
|Keywords:||Alzheimer's disease, Dementia, Frontotemporal dementia, Neuropsychology|
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