Portuguese version of the CDR plus NACC FTLD: Validation studies

Area of Science:

• Neuroscience
• Clinical Neurology
• Psychometrics

Background:

• Frontotemporal lobar degeneration (FTLD) presents unique challenges in dementia diagnosis.
• The standard CDR Dementia Staging Instrument lacks specific domains for FTLD features.
• The CDR plus NACC FTLD was developed to address these diagnostic gaps.

Purpose of the Study:

• To validate the CDR plus NACC FTLD instrument in a European-Portuguese population.
• To assess the tool's ability to differentiate behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) and healthy controls.

Main Methods:

• A cohort of 105 participants (35 bvFTD, 35 AD, 35 controls) matched for age, education, and disease stage was recruited.
• A blinded neuropsychologist administered a translated version of the CDR plus NACC FTLD, including its language and behavior/personality domains.
• Logistic regression analyses were employed to evaluate diagnostic discrimination.

Main Results:

• The bvFTD group exhibited significantly higher CDR plus NACC FTLD scores compared to AD and control groups.
• The sum-of-boxes, behavior/personality, and language domains demonstrated significant ability to distinguish between clinical groups.
• Inclusion of the behavior/personality domain, with or without the language domain, substantially enhanced diagnostic discrimination.

Conclusions:

• The CDR plus NACC FTLD is a validated and reliable instrument for the diagnostic evaluation of bvFTD.
• This enhanced CDR tool provides added value in differentiating bvFTD from AD, aiding clinical decision-making.