Clinical Validation of the Behavioral Evaluation Scale of Frontotemporal Dementia: A Pilot Study

Besides cognitive deficits, dementias are characterized by behavioral symptoms, hampering efforts to distinguish between different types of dementia, such as Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Moreover, instruments adapted to the local sociocultural context are lacking in non-English-speaking countries. The authors developed a scoring instrument (the Behavioral Evaluation Scale of Frontotemporal Dementia [BES-FTD]) for use in the Latin American context to assess behavioral changes among patients with bvFTD and to test its accuracy to differentiate bvFTD from AD.

The BES-FTD and the Cambridge Behavioral Inventory-Revised (CBI-R) were administered to three groups of participants: patients with probable bvFTD, patients with probable AD, and cognitively healthy individuals (control). The authors investigated diagnostic accuracies with receiver operating characteristic (ROC) curve analysis.

The sample comprised 86 participants matched on sex, age, and education: bvFTD group, N=26; AD group, N=16; and healthy control group, N=44. The AD and bvFTD groups were also matched on the severity of disease. The individuals in the bvFTD group had significantly higher scores on the BES-FTD and on the CBI-R compared with the control and AD groups, indicating more severe behavioral disorders. ROC curve analysis indicated an area under the curve of 0.86 for the BES-FTD and 0.58 for the CBI-R. The BES-FTD had higher specificity (93.7%) than the CBI-R (81.2%).

The BES-FTD provided higher diagnostic accuracy than the CBI-R for distinguishing between bvFTD and AD, demonstrating the clinical usefulness of the BES-FTD. Future studies are needed to confirm these results.