BvFTD

Unfortunately, accurate identification of Behavioral variant FrontoTemporal Dementia (bvFTD) can be difficult for clinicians, including primary care physicians, geriatricians, general psychiatrists and general neurologists, who do not specialize in the assessment of neurodegenerative syndromes. bvFTD is a neurodegenerative disorder caused by focal degeneration of the frontal and anterior temporal lobes; it has an incidence and prevalence similar to Alzheimer’s disease (AD) among young-onset patients. bvFTD is often mistaken for AD or other conditions including psychiatric disorders, such as late-onset schizophrenia, atypical psychosis and depression. Alternatively, though non-specialist clinicians have become more aware of bvFTD as an entity, they may erroneously interpret their patients’ symptoms as indicating bvFTD when the patient has another neurologic or psychiatric disorder. Patients with AD presenting with agitation and aggression, which occur frequently in AD, can be diagnosed as bvFTD due to the difficulty of delineating the whole symptom profile necessary for differential diagnosis. The resulting confusion and social upheaval for the patient and their family can be highly distressing. The diagnosis of bvFTD relies upon subjective behavioral features, including behavioral disinhibition, apathy or loss of interest, loss of sympathy or empathy, compulsive stereotypic behavior and dietary changes. An accurate diagnosis is important because bvFTD affects patients’ lives and has profound implications for their families and communities. Burden and stress are higher among bvFTD caregivers than those of patients with AD or other dementias. When patients are given an incorrect diagnosis, they may receive inappropriate treatment causing increased distress. Previous reports suggest that problems leading to misdiagnosis of bvFTD include patients’ younger age at onset and failure of clinicians to obtain key diagnostic information.

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