Are we comparing frontotemporal dementia and Alzheimer disease patients with the right measures?
Are we comparing frontotemporal dementia and Alzheimer disease patients with the right measures?
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DOI：
10.1017/s1041610216000582
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发表时间：
2016-09-01
影响因子：
7
通讯作者：
Mendez, Mario F.
中科院分区：
文献类型：
--
作者：
Deutsch, Mariel B.;Liang, Li-Jung;Mendez, Mario F.
背景：行为变异性额颞叶痴呆（bvFTD）的临床研究通常以阿尔茨海默病（AD）作为痴呆变量控制的对照组，使用认知功能测试来匹配两组。然而，这两种痴呆综合征在临床表现上非常不同，这些痴呆的可比严重程度可能无法通过常用的认知量表（如迷你精神状态检查（MMSE））反映出来。方法：我们评估了20名bvFTD患者和24名早发性AD患者痴呆严重程度和症状的不同测量方法。结果：尽管在MMSE和蒙特利尔认知评估（MoCA）两项认知功能测试中，bvFTD参与者的年龄、病程、受教育程度和认知表现相似，但与AD参与者相比，bvFTD参与者在其他疾病严重程度测量上明显受损，包括功能（功能评估问卷（FAQ））、神经精神症状（神经精神量表（NPI））和总体痴呆分期（临床痴呆评定量表（CDRs））。然而，当我们在分析中调整额颞叶变性- cdr （FTLD-CDR）时，尽管在认知量表上存在显着差异，但两个痴呆组在所有测量中都具有可比性。结论：我们发现认知功能测试（MMSE和MoCA）不足以确保bvFTD和AD组之间的可比性。在临床研究中，FTLD-CDR，包括额外的语言和行为项目，可能是一个更好的整体方法来匹配bvFTD和AD组的痴呆严重程度。
Background: Clinical research studies of behavioral variant frontotemporal dementia (bvFTD) often use Alzheimer disease (AD) as a comparison group for control of dementia variables, using tests of cognitive function to match the groups. These two dementia syndromes, however, are very different in clinical manifestations, and the comparable severity of these dementias may not be reflected by commonly used cognitive scales such as the Mini-Mental State Examination (MMSE).Methods: We evaluated different measures of dementia severity and symptoms among 20 people with bvFTD compared to 24 with early-onset AD.Results: Despite similar ages, disease-duration, education, and cognitive performance on two tests of cognitive function, the MMSE and the Montreal Cognitive Assessment (MoCA), the bvFTD participants, compared to the AD participants, were significantly more impaired on other measures of disease severity, including function (Functional Assessment Questionnaire (FAQ)), neuropsychiatric symptoms (Neuropsychiatric Inventory (NPI)), and global dementia stage (Clinical Dementia Rating Scales (CDRs)). However, when we adjusted for the frontotemporal lobar degeneration-CDR (FTLD-CDR) in the analyses, the two dementia groups were comparable across all measures despite significant differences on the cognitive scales.Conclusion: We found tests of cognitive functions (MMSE and MoCA) to be insufficient measures for ensuring comparability between bvFTD and AD groups. In clinical studies, the FTLD-CDR, which includes additional language and behavior items, may be a better overall way to match bvFTD and AD groups on dementia severity.