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Clinical considerations regarding suspected "BvFTD-by-proxy": a case series.

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Informant reports can misdiagnose behavioral variant frontotemporal dementia (bvFTD). Recognizing "bvFTD-by-proxy" cases is crucial for patient autonomy and accurate diagnosis, requiring careful clinical evaluation.

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Area of Science:

  • Neurology
  • Psychiatry
  • Gerontology

Background:

  • Diagnosis of behavioral variant frontotemporal dementia (bvFTD) often relies on informant reports of behavioral changes.
  • The concept of "bvFTD-by-proxy" highlights situations where informant objectivity may be questionable.

Purpose of the Study:

  • To present cases of bvFTD-like symptoms attributed to spousal reports.
  • To explore the challenges in diagnosing bvFTD when subjective informant data is prominent.

Main Methods:

  • Case series presentation of three individuals with bvFTD-like symptoms.
  • Review of clinical evaluations including neuropsychological testing and neuroimaging.
  • Analysis of informant (spousal) reports regarding behavioral changes.

Main Results:

  • Symptoms were reported by spouses, but progression was unclear.
  • Neuropsychological testing revealed mild, stable executive dysfunction.
  • Neuroimaging results were unremarkable in all presented cases.

Conclusions:

  • Subjective informant reports, particularly from spouses, can lead to potential misdiagnosis of bvFTD.
  • Relational discord may influence informant objectivity, impacting patient autonomy.
  • Careful clinical assessment and management are essential to address "bvFTD-by-proxy" scenarios and protect patient rights.