Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network
Abstract 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...
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2021-01-01
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Series: | Alzheimer’s Research & Therapy |
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Online Access: | https://doi.org/10.1186/s13195-020-00753-9 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mélanie Leroy Maxime Bertoux Emilie Skrobala Elisa Mode Catherine Adnet-Bonte Isabelle Le Ber Stéphanie Bombois Pascaline Cassagnaud Yaohua Chen Vincent Deramecourt Florence Lebert Marie Anne Mackowiak Adeline Rollin Sillaire Marielle Wathelet Florence Pasquier Thibaud Lebouvier the Méotis network |
spellingShingle |
Mélanie Leroy Maxime Bertoux Emilie Skrobala Elisa Mode Catherine Adnet-Bonte Isabelle Le Ber Stéphanie Bombois Pascaline Cassagnaud Yaohua Chen Vincent Deramecourt Florence Lebert Marie Anne Mackowiak Adeline Rollin Sillaire Marielle Wathelet Florence Pasquier Thibaud Lebouvier the Méotis network Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network Alzheimer’s Research & Therapy Frontotemporal dementia Epidemiology Progression Dementia |
author_facet |
Mélanie Leroy Maxime Bertoux Emilie Skrobala Elisa Mode Catherine Adnet-Bonte Isabelle Le Ber Stéphanie Bombois Pascaline Cassagnaud Yaohua Chen Vincent Deramecourt Florence Lebert Marie Anne Mackowiak Adeline Rollin Sillaire Marielle Wathelet Florence Pasquier Thibaud Lebouvier the Méotis network |
author_sort |
Mélanie Leroy |
title |
Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network |
title_short |
Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network |
title_full |
Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network |
title_fullStr |
Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network |
title_full_unstemmed |
Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network |
title_sort |
characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network |
publisher |
BMC |
series |
Alzheimer’s Research & Therapy |
issn |
1758-9193 |
publishDate |
2021-01-01 |
description |
Abstract 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. |
topic |
Frontotemporal dementia Epidemiology Progression Dementia |
url |
https://doi.org/10.1186/s13195-020-00753-9 |
work_keys_str_mv |
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doaj-b634756d0e1a42a3a0dc64db05e213002021-01-10T12:55:00ZengBMCAlzheimer’s Research & Therapy1758-91932021-01-0113111110.1186/s13195-020-00753-9Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic networkMélanie Leroy0Maxime Bertoux1Emilie Skrobala2Elisa Mode3Catherine Adnet-Bonte4Isabelle Le Ber5Stéphanie Bombois6Pascaline Cassagnaud7Yaohua Chen8Vincent Deramecourt9Florence Lebert10Marie Anne Mackowiak11Adeline Rollin Sillaire12Marielle Wathelet13Florence Pasquier14Thibaud Lebouvier15the Méotis networkUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzBiostastitic department, CHU Lille, DistALzUniv. Lille, Inserm, CHU LilleUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzSorbonne Université, Inserm U1127, CNRS UMR 7225, Institut du Cerveau (ICM), AP-HP - Hôpital Pitié-SalpêtrièreUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzDepartment of Public Health, CHU LilleUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzUniv. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, CNRMAJ, LiCEND, DistAlzAbstract 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.https://doi.org/10.1186/s13195-020-00753-9Frontotemporal dementiaEpidemiologyProgressionDementia |