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The prevalence of frontal variant frontotemporal dementia and the frontal lobe syndrome in a population based sample of 85 year olds
  1. T B Gislason,
  2. M Sjögren,
  3. L Larsson,
  4. I Skoog
  1. The Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska Hospital, Gothenburg, Sweden
  1. Correspondence to:
 Dr T B Gislason, The Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska Hospital, S413 45 Gothenburg, Sweden;
 thorstgi{at}landspitali.is

Abstract

Objectives: To investigate the prevalence of the frontal lobe syndrome (FLS) and the frontal variant of frontotemporal dementia (fvFTD) in a population based sample of 85 year olds.

Methods: A representative sample of 85 year olds (n = 451) in Gothenburg, Sweden was examined with a neuropsychiatric examination and a key informant interview performed by an experienced psychiatrist. A subsample underwent computed tomography (CT) of the head. The Lund-Manchester research criteria were used as a basis for a symptom algorithm to identify individuals with FLS and fvFTD. These were diagnosed blindly to the diagnosis of dementia according to DSM-III-R.

Results: A total of 86 individuals (19%) fulfilled the criteria for FLS, and 14 of them fulfilled criteria for fvFTD. There were no differences between men and women. Among those with FLS, 75 (87%) fulfilled DSM-III-R criteria for other types of dementia, mainly Alzheimer's disease and vascular dementia. Among the 14 fvFTD cases, only five were demented according to DSM-III-R. Moderate to severe frontal atrophy was found in 93% of those with FLS (and in all cases with fvFTD), but also in 49% of those without FLS. FLS was found in 35% of those with moderate to severe frontal atrophy, and in 3% of those without these changes.

Conclusions: The prevalence of fvFTD was 3% in 85 year olds, which is higher than previously expected in this age group. Only a minority of those with fvFTD were detected by the DSM-III-R criteria for dementia. FLS was even more common, especially in those diagnosed with a dementia disorder.

  • frontotemporal dementia
  • frontal lobe syndrome
  • prevalence
  • population study
  • computerised tomography
  • AD, Alzheimer's disease
  • CT, computed tomography
  • EEG, electroencephalography
  • FLS, frontal lobe syndrome
  • FTD, frontotemporal dementia
  • fvFTD, frontal variant frontotemporal dementia
  • LMRC, Lund-Manchester research criteria
  • SPECT, single photon emission computed tomography
  • VAD, vascular dementia
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Footnotes

  • Competing interests: None declared

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