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Frontal-executive Versus Posterior-perceptual Mental Status Deficits in Early-onset Dementias

Department of Neurology, Neurobehavior Unit, VA Greater Los Angeles Healthcare System, mmendez{at}ucla.edu, David Geffen School of Medicine, University of California at Los Angeles Los Angeles, California

Aaron M. McMurtray, MD, PhD

Department of Neurology, Neurobehavior Unit, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, University of California at Los Angeles Los Angeles, California

Eliot A. Licht, MD

Department of Neurology, Neurobehavior Unit, VA Greater Los Angeles Healthcare System

Ronald E. Saul, MD

David Geffen School of Medicine, University of California at Los Angeles Los Angeles, California

Background: Compared to late-onset dementias, early-onset dementias (EODs) may have greater focal cognitive involvement with differences in frontal-executive compared to posterior-perceptual deficits. Objective: This study evaluated whether mental status screening based on this frontal-posterior axis can distinguish EODs. Methods: Twenty-three patients each with early-onset Alzheimer's disease (eAD), frontotemporal dementia (FTD), or subcortical ischemic vascular disease (SIVD), and 20 normal controls underwent the Frontal Assessment Battery (FAB) and the Perceptual Assessment Battery (PAB). Results: Compared to controls, SIVD and FTD groups were impaired on the FAB whereas eAD and SIVD groups were impaired on the PAB. The FAB/PAB ratio further differentiated the groups (F(3,85) = 26.49, P < .001). For sensitivities and specificities of 93%, a cut-off score of 1.25 on the FAB/PAB distinguished eAD, and a cut-off of 0.83 distinguishing FTD. Conclusion: Although preliminary, this study indicates that mental status screening based on frontal versus posterior cortical functions may help clinicians diagnose EODs.

Key Words: dementia • Alzheimer's disease • vascular dementia • frontotemporal dementia • frontal-executive functions • perceptual disturbances

This version was published on June 1, 2009

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 24, No. 3, 220-227 (2009)
DOI: 10.1177/1533317509332626


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