Clinical Manifestations

The prevalence of frontotemporal dementia (FTD) is 1.9% over 65 years. There is a considerable delay in the diagnosis of FTD and a high rate of misdiagnosis in Latin America. We describe cognitive and neuropsychiatric features in a Peruvian cohort.

Participants have been recruited using Lima FTD network and then they were assessed by neurologists, neuropsychologists, and psychiatrists. The participants completed comprehensive neuropsychological battery, neuropsychiatric and functional assessments. IRB approval was obtained from CIEI-INCN.

We studied 18 FTD cases and 39 matched controls. The FTD group had 72.22% males, while the control group had 53.85%. The mean age at onset in the FTD group was 55.94 ± 9.24 years, and at evaluation it was 58.61 ± 8.83 years while in control group the mean age was 61.54 ± 5.92 years. FTD patients had 13.11 ± 3.61 years of education, significantly higher than 7.33 ± 1.15 years in controls (p = 0.000). Diagnoses were: 16 (88.9%) BvFTD and 2 (11.1%) semantic PPA. Most common symptoms included dysexecutive dysfunction (100%), disinhibition, apathy, and perseverative behavior (88.9% each). ACE scores were much lower in FTD (34.88 ± 21.39) than controls (83.26 ± 17.21, p =  0.000), as were INECO frontal screening (5.3 ± 4.08 vs. 17.18 ± 4.6, p =  0.000) and Digit Forward scores (3.5 ± 2.22 vs. 7.05 ± 2.01, p =  0.000). According to the NPI, the most common symptoms were disinhibition (88.2%), apathy (82.4%), and aberrant motor behavior (76.5%). Dementia severity was rated using CDR: 16.7% had CDR=3, 66.7% had CDR=2, and 16.7% had CDR=1. Depressive symptoms averaged 3.8 ± 2.7 on the GDS. Correlations were not significant between years of education and cognitive performance or between GDS and CDR scores.

The clinical features of the FTD cohort in the Peruvian population are consistent with previous reports. Among the Peruvian FTD cohort, the main neuropsychiatric symptoms are disinhibition, apathy, and perseverative behavior.