We sought to identify the cognitive tests that best discriminate between Alzheimer’s disease (AD) and frontotemporal dementia (FTD). A comprehensive search of all studies examining the cognitive performance of persons diagnosed with AD and FTD, published between 1980 and 2006, was conducted. Ninety-four studies were identified, comprising 2936 AD participants and 1748 FTD participants. Weighted Cohen’s d effect sizes, percentage overlap statistics, confidence intervals and fail-safe Ns were calculated for each cognitive test that was used by two or more studies. The most discriminating cognitive tests were measures of orientation, memory, language, visuomotor function and general cognitive ability. Although there were large and significant differences between groups on these measures, there was substantial overlap in the scores of the AD and FTD groups. Age, education, years since diagnosis and diagnostic criteria did not significantly contribute to the group differences. Given the large overlap in the test performance of persons diagnosed with AD and FTD, cognitive tests should be used cautiously and in conjunction with a medical history, behavioural observations, imaging and information from relatives when making differential diagnoses.
- ACE, Addenbrooke’s Cognitive Examination
- AD, Alzheimer’s disease
- AVLT, Auditory Verbal Learning Test
- FTD, frontotemporal dementia
- MMSE, Mini-Mental State Examination
- Nfs, fail safe N
- %OL, percentage overlap
- WAB, Western Aphasia Battery
- WLS, weighted least squares
- WMS, Wechsler Memory Scale
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Published Online First 19 March 2007
Competing interests: None.