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Analysis of a case series of behavioral variant frontotemporal dementia: Emphasis on diagnostic delay

ANÁLISE DE UMA SÉRIE DE CASOS DE VARIANTE COMPORTAMENTAL DA DEMÊNCIA FRONTOTEMPORAL: ÊNFASE NO ATRASO DIAGNÓSTICO

ABSTRACT

Introduction:

Despite many advances in the characterization of the behavioral variant of frontotemporal dementia (bvFTD), the diagnosis of this syndrome poses a significant challenge, while delays or diagnostic mistakes may impact the proper clinical management of these patients.

Objective:

To describe the clinical profile at first evaluation of a sample of patients with bvFTD from a specialized outpatient neurological unit, with emphasis on the analysis of the delay between the onset of symptoms and diagnosis.

Methods:

We selected 31 patients that fulfilled international consensus criteria for possible or probable bvFTD. Patients' medical admission sheets were thoroughly reviewed.

Results:

Patients' mean age was 67.9±8.2 years; 16 (51.6%) were men. Mean number of years of formal education was 7.7±4.0 years. Mean age at onset was 62.2±7.7 years, indicating a mean of 5.8 years of diagnostic delay. Thirteen patients (41.9%) presented with initial behavioral complaints only, eleven patients (35.5%) had mixed behavioral and memory complaints, five patients (16.1%) presented with memory complaints only, and two patient (6.4%) had behavioral and speech problems. Nine patients (29%) were admitted with alternative diagnoses. Mean and standard deviation scores for the mini-mental state examination, animal category fluency and memory test for drawings (five-minute delayed recall) were 19.3±6.3, 8.3±4.1 and 3.7±2.7, respectively.

Conclusion:

Most patients from this sample were evaluated almost six years after the onset of symptoms and performed poorly on both cognitive screening tests and functional evaluation measures.

Key words:
frontotemporal dementia; Alzheimer's disease; dementia; diagnosis

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br