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[Late-onset frontotemporal degenerations].

Frederic Bertrand1, Anaïs Gaudiez2, Anne-Sophie Valadoux3

  • 1Hôpital universitaire de Bruxelles, Bruxelles, Belgique.

Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement
|May 11, 2026
PubMed
Summary
This summary is machine-generated.

Late-onset frontotemporal lobar degeneration (FTLD) is increasingly recognized in older adults, presenting unique diagnostic challenges due to subtle symptoms and distinct neuropathology. Early and accurate diagnosis requires integrating multiple data types for effective patient management.

Keywords:
biomarkerscognitive dysfunctionelderly peoplefrontotemporal lobar degenerationneuropathology

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Area of Science:

  • Neurology
  • Neuroscience
  • Geriatrics

Background:

  • Frontotemporal lobar degeneration (FTLD) is a group of neurodegenerative disorders.
  • Late-onset FTLD is underdiagnosed, challenging the view of FTLD as primarily affecting younger individuals.
  • Incidence of FTLD increases with age, peaking in the seventh decade.

Purpose of the Study:

  • To highlight the diagnostic challenges of late-onset FTLD.
  • To discuss the distinct clinical and neuropathological features of late-onset FTLD.
  • To emphasize the need for a multimodal diagnostic approach in older adults.

Main Methods:

  • Review of epidemiological studies on FTLD incidence.
  • Analysis of clinical and neuropathological features distinguishing late-onset from early-onset FTLD.
  • Discussion of diagnostic strategies including clinical evaluation, neuroimaging, and biomarkers.

Main Results:

  • Late-onset FTLD presents with atypical phenotypes, including mild behavioral changes, memory issues mimicking Alzheimer's disease, and subtle motor/language deficits.
  • Neuropathology in late-onset FTLD shows less atrophy, more mixed pathologies, and age-related lesions.
  • Diagnostic accuracy is limited by the absence of typical early-onset features.

Conclusions:

  • Identifying late-onset FTLD in older adults requires a multimodal approach combining clinical, neuropsychological, imaging, and genetic data.
  • Cerebrospinal fluid biomarkers for Alzheimer's disease can aid diagnosis but require cautious interpretation.
  • Improved recognition and management of late-onset FTLD are crucial for this growing patient population.