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Cited by 47Dementia and Cognitive Impairment ResearchHistorical and Modern Theater StudiesAmyotrophic Lateral Sclerosis Research

When a little knowledge can be dangerous: false-positive diagnosis of behavioral variant frontotemporal dementia among community clinicians

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Shinagawa, Shunichiro, Catindig, Joseree Ann, Block, Nikolas R., Miller, Bruce L., Rankin, Katherine P.·2016·Dementia and Geriatric Cognitive Disorders
DOI 10.1159/000438454PMC PMC4835218
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Abstract

Background: Accurate diagnosis of behavioral variant frontotemporal dementia (bvFTD) is important as patients' behavioral symptoms have profound implications for their families and communities. Since the diagnosis of bvFTD derives from behavioral features, accurate identification of patients can be difficult for non-specialists. Concrete rates of diagnostic accuracy among non-specialists are unavailable. Methods: To examine the accuracy of community clinicians' diagnoses of bvFTD and to identify patient characteristics leading to misdiagnosis, we reviewed the charts and referral letters of 3,578 patients who were seen at our specialized center. Referral diagnosis and reasons, manifesting symptoms, demographic data, Mini-Mental State Examination score, Clinical Dementia Rating score and Neuropsychiatric Inventory score were extracted. Results: 60% of patients assigned a single diagnosis of bvFTD by community clinicians did not have bvFTD according to specialists. Compared to specialist-confirmed bvFTD patients, false bvFTD patients were more likely to be depressed and to be non-Caucasian, showed less euphoria, apathy, disinhibition and abnormal eating behaviors, had milder disease severity and better overall cognition. bvFTD was mentioned by referring clinicians in 86% of specialist-confirmed bvFTD cases, but missed cases were called Alzheimer's, Parkinson's or Huntington's disease, or progressive aphasia. Conclusion: These results revealed a widespread lack of familiarity with core diagnostic symptoms among non-specialists and suggest that community clinicians require specialized diagnostic support before providing a definitive diagnosis of bvFTD.

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Cited by

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Authors
Shinagawa, S., Catindig, J. A., Block, N. R., Miller, B. L., & Rankin, K. P.
Affiliations
University of California, San Francisco (US)
ORCID
Venue
Dementia and Geriatric Cognitive Disorders
Publisher
S. Karger AG
Published
2016
Volume
41
Issue
1-2
Pages
99-108
ISSN
  • 1420-8008 (ISSN-L)
  • 1421-9824
DOI
10.1159/000438454
PMC
PMC4835218
OpenAlex
W2254314164
Cited by
47
References
4
Citations by year
2026: 3 · 2025: 6 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 6 · 2018: 2 · 2017: 2 · 2016: 1
FWCI
3.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Dementia and Geriatric Cognitive Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Larry L. Hillblom Foundation (2007/2I)
  • National Institutes of Health
  • University of California, San Francisco (2007/2I, P50 AG023501, P01AG019724)
  • National Institute on Aging (R01AG029577, P01AG017586, RF1AG029577, 5-R01 AG029577, P01AG019724, P50AG023501)
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 › Neurology › Amyotrophic Lateral Sclerosis Research
Keywords
behavioral variant frontotemporal dementia, false-positive diagnosis, diagnostic accuracy, community clinicians, misdiagnosis, behavioral symptoms, neuropsychiatric symptoms, depression, diagnostic support, frontotemporal lobar degeneration
MeSH terms
Aged, Alzheimer Disease, Behavioral Symptoms, Depression, Diagnosis, Differential, Diagnostic Errors, False Positive Reactions, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Patient Care Team, Frontotemporal Dementia

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