Trajectories of behavioural disturbances across dementia types
Open accessAbstract
Objective: To replicate a previous finding that the trajectory of the Neuropsychiatric Inventory (NPI) shifts in the sixth year of behavioural variant frontotemporal dementia (bvFTD). We evaluated longitudinal tracking with both the Frontal Behavioural Inventory (FBI) and NPI, comparing bvFTD against other dementias.Methods: Chart reviews over two to five years for patients with bvFTD (n=30), primary progressive aphasia (PPA, n=13) and Alzheimer’s disease (AD, n=118) at an urban Canadian tertiary clinic specializing in dementia. Linear regressions of the longitudinal data tested predictors of annualized rates of change (ROC) in NPI and FBI total and subscales for apathy and disinhibition among dementia groups. Results: The mode of the overall sample for the most advanced duration of illness observed was 5 years, with the median at 7 years. We did not find a crescendo-decrescendo pattern in scores although, for bvFTD and AD, high initial scores correlated with ensuing downward ROCs on the NPI and FBI. Educational level showed an influence on disinhibition ROCs. The FBI was no more revealing than the NPI for apathy and disinhibition scores in these dementias. Conclusions: A cognitive reserve effect on behavioural disturbance was supported but it may take longer than our 4 years of observing the clinical sample to record inflection points in the behavioural and psychiatric symptoms seen in bvFTD. The current data only imply that both apathy and disinhibition will diminish over the course of dementia.
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The FBI and CBI-R were sensitive to progression in sporadic and genetic bvFTD (C9ORF72) more consistently than the NPI, over varying follow-up time (1-4 years).
“Literature showed the FBI and the CBI-R to be sensitive to progression in sporadic and genetic bvFTD (C9ORF72) more consistently than the NPI, over varying follow-up time (1–4 years), despite one study stating comparable decline of FBI and NPI (Marczinski et al., 2004; Boutoleau-Bretonniere et al., 2012; Linds et al., 2015; O’Connor et al., 2016; Floeter et al., 2017; Reus et al., 2018).”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Linds et al., 2015
The Neuropsychiatric Inventory generally showed increased scores during follow-up in bvFTD.
“The Neuropsychiatric Inventory (NPI), developed to evaluate psychopathology in AD (Cummings et al., 1994), generally showed increased scores during follow-up in bvFTD (Linds et al., 2015; Da Silva et al., 2021).”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Linds et al., 2015
One study did not report a behavioral inflection point during follow-up.
“While one study did not report such behavioral inflection point during follow-up (Linds et al., 2015), the relative reduction of positive symptoms may show improvement of behavioral scores over time (Knopman et al., 2008).”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Linds et al., 2015
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Wiels, W. A., Wittens, M. M. J., Zeeuws, D., Baeken, C., & Engelborghs, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.707580 · Cited by 52 · see citing works
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- Authors
- Linds, A. B., Kirstein, A. B., Freedman, M., Verhoeff, N. P. L. G., Wolf, U., & Chow, T. W.
- Affiliations
- Rotman Research Institute (CA)
- Wilfrid Laurier University (CA)
- Mount Sinai Hospital (CA)
- University of Toronto (CA)
- Corresponding author
- Chow, Tiffany W.
- Venue
- Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-09-02
- Volume
- 42
- Issue
- 6
- Pages
- 389-394
- ISSN
- 0317-1671 (ISSN-L)
- 2057-0155
- OpenAlex
- W2424906276
- Cited by
- 7
- References
- 23
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2016: 2
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- McGill University
- York University
- University of Toronto
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- behavioral variant frontotemporal dementia, neuropsychiatric symptoms, apathy, disinhibition, Alzheimer's disease, primary progressive aphasia, Neuropsychiatric Inventory, cognitive reserve, educational attainment, longitudinal symptom trajectories
- MeSH terms
- Problem Behavior, Adult, Aged, Cognition, Dementia, Female, Frontal Lobe, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Severity of Illness Index
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