Journal article
Frontotemporal Dementia in Elderly Individuals
Archives of neurology (Chicago), Vol.69(8), pp.1052-1060
08/01/2012
DOI: 10.1001/archneurol.2011.3323
PMID: 22529248
Abstract
Objective: To determine whether cases of frontotemporal lobar degeneration (FTLD) do exist in elderly individuals and have clinical and neuropathological features distinct from those with presenile onset.
Design: Retrospective matched cohort study.
Setting: Regional Neuroscience Centre, North East England.
Patients: We compared clinicopathological features of 11 cases of FTLD in elderly individuals with 19 cases of presenile-onset FTLD.
Results: Retrospective case note analysis showed that most elderly patients with FTLD had behavioral features consistent with orbitofrontal and basofrontal involvement, similar to presenile-onset FTLD, though symptomatic memory loss was present in 91% (10 of 11) of elderly patients with FTLD compared with only 36% (7 of 19) of patients with presenile-onset FTLD. Neuropathologically, the group of elderly patients with FTLD comprised 7 with FTLD-TDP-43, 1 with ubiquitin-positive FTLD, 2 with FTLD-tau/Pick disease, and 1 with FTLD-tau/neurofibrillary tangle-predominant dementia with TDP-43, a composition similar to presenile-onset FTLD. However, hippocampal sclerosis was more common in elderly patients with FTLD than patients with presenile-onset FTLD (82% vs 37%) and more severe in elderly patients with FTLD (P < .05). By contrast, severe atrophy of the frontal and temporal lobes was less common in elderly patients with FTLD (frontal: 45%; temporal: 27%) than patients with presenile-onset FTLD (frontal: 63%; temporal: 78%). Elderly patients with FTLD represented 3.2% of all elderly patients with dementia autopsied at Newcastle General Hospital.
Conclusions: Frontotemporal lobar degeneration in elderly patients does exist as a separate entity from presenile-onset FTLD. Its main features include (1) clinically frequent memory loss and behavioral change predominating over language and semantic dysfunction and (2) neuropathologically prominent hippocampal sclerosis but less pronounced cortical lobar atrophy. Clinically, FTLD in elderly patients is underrecognized and should be considered in the elderly subjects presenting with an "atypical Alzheimer disease" phenotype.
Details
- Title: Subtitle
- Frontotemporal Dementia in Elderly Individuals
- Creators
- Atik Baborie - Walton Ctr Neurol & Neurosurg, Dept Neuropathol, Liverpool L9 7LJ, Merseyside, EnglandTim D. Griffiths - Newcastle Univ, Sch Med, Inst Neurosci, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, EnglandEvelyn Jaros - Newcastle UniversityParastoo Momeni - Texas Tech Univ, Hlth Sci Ctr, Dept Internal Med, Lubbock, TX 79430 USAIan G. McKeith - Newcastle Univ, Inst Ageing & Hlth, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, EnglandDavid J. Burn - Newcastle Univ, Inst Ageing & Hlth, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, EnglandG. Keir - Walton Ctr Neurol & Neurosurg, Dept Neuropathol, Liverpool L9 7LJ, Merseyside, EnglandAndrew J. Larner - Walton Ctr Neurol & Neurosurg, Dept Neuropathol, Liverpool L9 7LJ, Merseyside, EnglandDavid M. Mann - University of ManchesterRobert Perry - Royal Victoria Infirm, Dept Neuropathol Cellular Pathol, Newcastle Upon Tyne NE1 4LP, Tyne & Wear, England
- Resource Type
- Journal article
- Publication Details
- Archives of neurology (Chicago), Vol.69(8), pp.1052-1060
- DOI
- 10.1001/archneurol.2011.3323
- PMID
- 22529248
- NLM abbreviation
- Arch Neurol
- ISSN
- 0003-9942
- eISSN
- 1538-3687
- Publisher
- American Medical Association
- Number of pages
- 9
- Grant note
- Alzheimer's Research Trust as part of the Brains for Dementia Research Project G0900652 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) Newcastle NIHR Biomedical Research Centre in Ageing and Age Related Diseases award G0400074; G1100540 / UK Medical Research Council; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) G1100540 / Medical Research Council; UK Research & Innovation (UKRI); Medical Research Council UK (MRC); European Commission UK National Institute for Health Research Biomedical Research Centre for Ageing and Age-Related Disease Award Alzheimer's Society
- Language
- English
- Date published
- 08/01/2012
- Academic Unit
- Psychological and Brain Sciences
- Record Identifier
- 9984627343602771
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