Inventários comportamentais e de atividades de vida diária no diagnóstico de degeneração lobar fronto-temporal e doença de Alzheimer

dn Dementia & Neuropsychologia Dement. neuropsychol. 1980-5764 Associação de Neurologia Cognitiva e do Comportamento Resumo O diagnóstico diferencial entre degeneração lobar fronto-temporal (DLFT) e doença de Alzheimer (DA) pode ser difícil em alguns casos. Objetivos: Verificar a utilidade de inventários comportamentais e de vida diária no diagnóstico diferencial entre DLFT e DA. Métodos: Foram entrevistados os cuidadores de 12 pacientes com DLFT (nove com demência fronto-temporal, dois com demência semântica e um com afasia progressiva não fluente) e de 12 pacientes com DA provável. As versões brasileiras dos questionáros Frontal Behavioral Inventory (FBI) e o Disability Assessment for Dementia (DAD ). Resultados: A média da pontuação do MEEM foi 12,4±10,7 para pacientes com DLFT e 11,9±6,2 para pacientes com DA (p=0.93). A média dos escores do DAD foi de 33,7±27,7 para pacientes com DLFT e 55,6±29,7 para pacientes com DA (p=0.06), enquanto que com relação ao FBI a média da pontuação foi de 42,6±10,0 para pacientes com DLFT e 16,7±11,7 para pacientes com DA (p<0.01). Conclusões: Neste estudo, o FBI apresentou uma boa acurácia no diagnóstico diferencial entre DFT e DA. Embora o DAD não tenha se mostrado útil no diagnóstico diferencial em nossa amostra, acreditamos que essa escala seja importante para analisar qualitativamente e quantitativamente os déficits funcionais dos pacientes, auxiliando na avaliação da gravidade do quadro demencial. Texto completo disponível apenas em PDF. Full text available only in PDF format. References 1 1. Ratnavalli E, Brayne C, Dawson K, Hodges JR. The prevalence of frontotemporal dementia. Neurology 2002;58:1615-1621. Ratnavalli E Brayne C Dawson K Hodges JR The prevalence of frontotemporal dementia Neurology 2002 58 1615 1621 2 2. Johnson JK, Dichl J, Mendez MF, et al. Frontotemporal lobar degeneration. Demographic characteristics of 353 patients. Arch Neurol 2005;62:925-930. Johnson JK Dichl J Mendez MF Frontotemporal lobar degeneration Demographic characteristics of 353 patients Arch Neurol 2005 62 925 930 3 3. Rosso SM, Kaat LD, Baks T, et al. Frontotemporal dementia in The Netherlands: patient characteristics and prevalence estimates from a population-based study. Brain 2003;126:2016-2022. Rosso SM Kaat LD Baks T Frontotemporal dementia in The Netherlands patient characteristics and prevalence estimates from a population-based study Brain 2003 126 2016 2022 4 4. Harvey RJ, Skelton-Robinson M, Rossor MN. The prevalence and causes of dementia in people under the age of 65 years. J Neurol Neurosurg Psychiatry 2003;74:1206-209. Harvey RJ Skelton-Robinson M Rossor MN The prevalence and causes of dementia in people under the age of 65 years J Neurol Neurosurg Psychiatry 2003 74 1206 1209 5 5. Takada LT, Caramelli P, Radanovic M, et al. Prevalence of potentially reversible dementias in a dementia outpatient clinic of a tertiary university-affiliated hospital in Brazil. Arq Neuropsiquiatr 2003;61:925-929. Takada LT Caramelli P Radanovic M Prevalence of potentially reversible dementias in a dementia outpatient clinic of a tertiary university-affiliated hospital in Brazil Arq Neuropsiquiatr 2003 61 925 929 6 6. Fulihara S, Brucki SM, Rocha MSG. Prevalence of presenile dementia in a tertiary outpatient clinic. Arq Neuropsiquiatr 2004;62:592-595. Fulihara S Brucki SM Rocha MSG Prevalence of presenile dementia in a tertiary outpatient clinic Arq Neuropsiquiatr 2004 62 592 595 7 7. Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration. A consensus on clinical diagnostic criteria. Neurology 1998;51:1546-1554. Neary D Snowden JS Gustafson L Frontotemporal lobar degeneration A consensus on clinical diagnostic criteria Neurology 1998 51 1546 1554 8 8. Gorno-Tempini ML, Dronkers NF, Rankin KP, et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 2004;55:335-346. Gorno-Tempini ML Dronkers NF Rankin KP Cognition and anatomy in three variants of primary progressive aphasia Ann Neurol 2004 55 335 346 9 9. Herrera E Jr, Caramelli P, Silveira AS, Nitrini R. Epidemiologic survey of dementia in a community-dwelling Brazilian population. Alzheimer Dis Assoc Disord 2002;16:103-108. Herrera E Jr Caramelli P Silveira AS Nitrini R Epidemiologic survey of dementia in a community-dwelling Brazilian population Alzheimer Dis Assoc Disord 2002 16 103 108 10 10. Qiu C, De Ronchi D, Fratiglioni L. The epidemiology of the dementias: an update. Curr Opin Psychiatry 2007;20:380-385. Qiu C De Ronchi D Fratiglioni L The epidemiology of the dementias an update Curr Opin Psychiatry 2007 20 380 385 11 11. Rosen HJ, Hartikainen KM, Jagust W, et al. Utility of clinical criteria in differentiating frontotemporal lobar degeneration (FTLD) from AD. Neurology 2002;58:1608-1615. Rosen HJ Hartikainen KM Jagust W Utility of clinical criteria in differentiating frontotemporal lobar degeneration (FTLD) from AD Neurology 2002 58 1608 1615 12 12. Kelley BJ, Petersen RC. Alzheimer's disease and mild cognitive impairment. Neurol Clin 2007;25:577-609. Kelley BJ Petersen RC Alzheimer's disease and mild cognitive impairment Neurol Clin 2007 25 577 609 13 13. Bustamante SEZ, Bottino CMC, Lopes MA, et al. Instrumentos combinados na avaliação de demência em idosos. Arq Neuropsiquiatr 2003;61:601-606. Bustamante SEZ Bottino CMC Lopes MA Instrumentos combinados na avaliação de demência em idosos Arq Neuropsiquiatr 2003 61 601 606 14 14. Shu GH, Ju YS, Yeon BK, Shah A. A longitudinal study of Alzheimer's disease: rates of cognitive and functional decline. Int J Geriatr Psichiatry 2004;19:817-824. Shu GH Ju YS Yeon BK Shah A A longitudinal study of Alzheimer's disease rates of cognitive and functional decline Int J Geriatr Psichiatry 2004 19 817 824 15 15. Mendez MF, Selwood A, Mastri AR, Frey WH. Pick's disease versus Alzheimer's disease: a comparison of clinical characteristics. Neurology 1993;43:289-292. Mendez MF Selwood A Mastri AR Frey WH Pick's disease versus Alzheimer's disease a comparison of clinical characteristics Neurology 1993 43 289 292 16 16. Pijinenburg YAL, Gillissen F, Jonker C, Scheltens P. Initial complaints in frontotemporal lobar degeneration. Dement Geriatr Cogn Disord 2004;17:302-306. Pijinenburg YAL Gillissen F Jonker C Scheltens P Initial complaints in frontotemporal lobar degeneration Dement Geriatr Cogn Disord 2004 17 302 306 17 17. Bahia VS. Underdiagnosis of Frontotemporal Lobar Degeneration in Brazil. Dement Neuropsychol 2007;1:361-365. Bahia VS Underdiagnosis of Frontotemporal Lobar Degeneration in Brazil Dement Neuropsychol 2007 1 361 365 18 18. Liscic RM, Storandt M, Cairns NJ, Morris JC. Clinical and psychometric distinction of Frontotemporal and Alzheimer dementias. Arch Neurol 2007;64:535-540. Liscic RM Storandt M Cairns NJ Morris JC Clinical and psychometric distinction of Frontotemporal and Alzheimer dementias Arch Neurol 2007 64 535 540 19 19. Kertesz A, Davidson W, McCabe P, Munoz D. Behavioral quantification is more sensitive than cognitive testing in frontotemporal dementia. Alzheimer Dis Assoc Disord 2003;17: 223-229 Kertesz A Davidson W McCabe P Munoz D Behavioral quantification is more sensitive than cognitive testing in frontotemporal dementia Alzheimer Dis Assoc Disord 2003 17 223 229 20 20. Hutchinson AD, Mathias JL. Neuropsychological deficits in frontotemporal dementia and Alzheimer's disease: a meta-analytic review. J Neurol Neurosurg Psychiatry 2007;78:917-928. Hutchinson AD Mathias JL Neuropsychological deficits in frontotemporal dementia and Alzheimer's disease a meta-analytic review J Neurol Neurosurg Psychiatry 2007 78 917 928 21 21. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSMIV. 4th ed. Washington DC: American Psychiatric Association, 1984:139-143. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders: DSMIV 4th Washington DC American Psychiatric Association 1984 139 143 22 22. Marra TA, Pereira LSM, Faria CDCM, et al. Avaliação das atividades de vida diária de idosos com diferentes níveis de demência. Rev Bras Fisiot (São Carlos) 2007;11:267-273. Marra TA Pereira LSM Faria CDCM Avaliação das atividades de vida diária de idosos com diferentes níveis de demência Rev Bras Fisiot (São Carlos) 2007 11 267 273 23 23. Mioshi E, Kipps CM, Dawson K, Mitchell J, Graham A, Hodges JR. Activities of daily living in frontotemporal dementia and Alzheimer disease. Neurology 2007;68:2077-2084. Mioshi E Kipps CM Dawson K Mitchell J Graham A Hodges JR Activities of daily living in frontotemporal dementia and Alzheimer disease Neurology 2007 68 2077 2084 24 24. McKhann G, Drachman D, Folstein M. Clinical diagnosis of Alzheimer's disease: Report of the NINCDS/ADRDA workgroup under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984;34:939-944. McKhann G Drachman D Folstein M Clinical diagnosis of Alzheimer's disease Report of the NINCDS/ADRDA workgroup under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease Neurology 1984 34 939 944 25 25. Nitrini R, Lefèvre BH, Mathias SC, et al. Testes neuropsicológicos de aplicação simples para o diagnóstico de demência. Arq Neuropsiquiatr 1994;52:457-465. Nitrini R Lefèvre BH Mathias SC Testes neuropsicológicos de aplicação simples para o diagnóstico de demência Arq Neuropsiquiatr 1994 52 457 465 26 26. Nitrini R, Caramelli P, Porto CS, et al. Brief cognitive battery in the diagnosis of mild Alzheimer's disease in subjects with medium and high levels of education. Dement Neuropsychol 2007;1:32-36 Nitrini R Caramelli P Porto CS Brief cognitive battery in the diagnosis of mild Alzheimer's disease in subjects with medium and high levels of education Dement Neuropsychol 2007 1 32 36 27 27. Mattis S. Mental Status Examination for Organic Mental Syndrome in the Elderly Patient. In: Bellak L, Karasu TB, editors. Geriatric Psychiatry. A Handbook for Psychiatrists and Primary Care Physicians. New York: Grune & Stratton; 1976:77-121. Mattis S Mental Status Examination for Organic Mental Syndrome in the Elderly Patient Bellak L Karasu TB Geriatric Psychiatry. A Handbook for Psychiatrists and Primary Care Physicians New York Grune & Stratton 1976 77 121 28 28. Pfeffer RI, Kusosaki TT, Harrah Jr CH, et al. Measurement of functional activities in older adults in the community. J Gerontol 1982;37:323-329. Pfeffer RI Kusosaki TT Harrah CH Jr Measurement of functional activities in older adults in the community J Gerontol 1982 37 323 329 29 29. Gélinas I, Gauthier L, McIntyre M, Gauthier S. Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia. Am J Occup Ther 1999;53:471-481. Gélinas I Gauthier L McIntyre M Gauthier S Development of a functional measure for persons with Alzheimer's disease the disability assessment for dementia Am J Occup Ther 1999 53 471 481 30 30. Carthery-Goulart MT, Areza-Fegyveres R, Schultz RR, et al. Adaptação transcultural da Escala de Avaliação de Incapacidade em Demência (Disability Assessment for Dementia - DAD) Arq Neuropsiquiatr 2007;65:916-919. Carthery-Goulart MT Areza-Fegyveres R Schultz RR Adaptação transcultural da Escala de Avaliação de Incapacidade em Demência (Disability Assessment for Dementia - DAD) Arq Neuropsiquiatr 2007 65 916 919 31 31. Kertesz A, Davidson W, Fox H. Frontal Behavioral Inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci 1997;24:29-36. Kertesz A Davidson W Fox H Frontal Behavioral Inventory diagnostic criteria for frontal lobe dementia Can J Neurol Sci 1997 24 29 36 32 32. Cummings JL, Mega MS, Gray K et al. The neuropsychiatry Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308-2314. Cummings JL Mega MS Gray K et al The neuropsychiatry Inventory comprehensive assessment of psychopathology in dementia Neurology 1994 44 2308 2314 33 33. Blair M, Davis-Faroque N, Hsiung GYR, et al. Behavioural measures in frontotemporal degeneration and other dementias: the utility of the Frontal Behavioural Inventory in a national cohort study. Dement Geriatr Cogn Disord 2007;23: 406-415. Blair M Davis-Faroque N Hsiung GYR Behavioural measures in frontotemporal degeneration and other dementias the utility of the Frontal Behavioural Inventory in a national cohort study Dement Geriatr Cogn Disord 2007 23 406 415 34 34. Kertesz A, Nadkarni N, Davidson W, Thomas AW. The Frontal Behavioral Inventory in the differential diagnosis of frontotemporal dementia. J Int Neuropsychol Soc 2000;6:460-468. Kertesz A Nadkarni N Davidson W Thomas AW The Frontal Behavioral Inventory in the differential diagnosis of frontotemporal dementia J Int Neuropsychol Soc 2000 6 460 468 35 35. Alberici A, Geroldi C, Cotelli M, et al. The Frontal Behavioral Inventory (Italian version) differentiates frontotemporal lobar degeneration variants from Alzheimer's disease. Neurol Sci 2007;28:80-86. Alberici A Geroldi C Cotelli M The Frontal Behavioral Inventory (Italian version) differentiates frontotemporal lobar degeneration variants from Alzheimer's disease Neurol Sci 2007 28 80 86 36 36. Caixeta LF. Neurobiologia e fenomenologia dos distúrbios da auto-consciência na demência fronto-temporal e na doença de Alzheimer. Tese. São Paulo: Universidade de São Paulo, 2001. Caixeta LF Neurobiologia e fenomenologia dos distúrbios da auto-consciência na demência fronto-temporal e na doença de Alzheimer 2001 São Paulo Universidade de São Paulo 37 37. Peres K, Helmer C, Amieva H, et al. Natural History of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. J Am Geriatr Soc 2008; 56:37-44. Peres K Helmer C Amieva H Natural History of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia a prospective population-based study J Am Geriatr Soc 2008 56 37 44