Monthly Archives: March 2007

“The Other Dementia” – SF Chronicle article about frontotemporal dementia

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This is a terrific, recently-published article from the San Francisco Chronicle. The article notes that UCSF is at the forefront of studying
frontotemporal dementia (FTD). The author, Katherine Nichols ([email protected]), has
first-hand experience with FTD and wants to raise awareness about early-onset
dementia.

Note that both progressive supranuclear palsy (PSP) and corticobasal
degeneration (CBD) — two disorders in our support group — are considered
related disorders.

Here’s a link to the article in the Chronicle:

http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2007/02/25/CMGSQNSC8F1.DTL

The Other Dementia
UCSF is at the forefront studying frontotemporal dementia, a wasting
disease similar to Alzheimer’s that strikes patients at their peak
San Francisco Chronicle
by Katherine Nichols
Sunday, February 25, 2007

Copied below is the short section on definitions and resources.

Robin

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Exerpt from:

The Other Dementia
UCSF is at the forefront studying frontotemporal dementia, a wasting
disease similar to Alzheimer’s that strikes patients at their peak
San Francisco Chronicle
by Katherine Nichols
Sunday, February 25, 2007

Help for caregivers

Frontotemporal dementia (also called frontotemporal lobar degeneration) is
an umbrella term that covers several disease subtypes. They are named
according to the way the disease began. Doctors agree that, as each one
progresses, the severity of symptoms may vary, but they all begin to
resemble one another.

Primary progressive aphasia or progressive non-fluent aphasia: Begins with
language disorder and may remain isolated there for up to two years. All
patients suffer behavioral symptoms and cognitive decline as the disease
spreads.

Semantic dementia: Language problems initially, primarily with
comprehension.

Pick’s disease: Immortalized in a tragic plot turn in Sue Monk Kidd’s “The
Mermaid’s Chair” and first described by Arnold Pick in 1892. Behavioral
symptoms exhibited first.

Corticobasal degeneration: Begins with motor control and coordination
problems.

Progressive supranuclear palsy: A related disorder that begins with
problems with gait and balance.

On the Web
University of California San Francisco Memory and Aging Center:
www.memory.ucsf.edu (includes information about support group meetings)

Association for Frontotemporal Dementias: www.ftd-picks.org; (866)
507-7222.

In print
“What If It’s Not Alzheimer’s: A Guide to Dementia,” by Lisa Radin

Differentiating DLB from AD (Neurology ’04, Ferman)

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This 2004 medical journal article is about differentiating Dementia with Lewy Bodies (DLB) from Alzheimer’s Disease (AD) and normal aging. The lead author of this article is on the Scientific Advisory Council of the Lewy Body Dementia Association. I’ve copied the abstract below.

The abstract notes that “four characteristics of fluctuations were found to significantly differentiate AD from DLB, (including) daytime drowsiness and lethargy, daytime sleep of 2 or more hours, staring into space for long periods, and episodes of disorganized speech.”

If your eyes glaze over on the abstract, read the Science Daily article from January 16, 2004 on this research!

https://www.sciencedaily.com/releases/2004/01/040116080751.htm

Robin
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www.neurology.org/cgi/content/abstract/62/2/181

NEUROLOGY 2004;62:181-187

DLB fluctuations
Specific features that reliably differentiate DLB from AD and normal aging

T. J. Ferman, PhD, G. E. Smith, PhD, B. F. Boeve, MD, R. J. Ivnik, PhD, R. C. Petersen, MD PhD, D. Knopman, MD, N. Graff-Radford, MBBCh MRCP, J. Parisi, MD and D. W. Dickson, MD

From the Department of Psychiatry and Psychology (Dr. Ferman), Mayo Clinic and Foundation, Jacksonville, FL; and Departments of Psychiatry and Psychology (Drs. Smith and Ivnik), Neurology (Drs. Boeve, Petersen, Knopman, and Graff-Radford), and Pathology (Drs. Parisi and Dickson), Mayo Clinic and Foundation, Rochester, MN.

Objective: To determine whether certain aspects of fluctuations reliably distinguish dementia with Lewy bodies (DLB) from Alzheimer’s disease (AD) and normal aging.

Methods: Participants included 200 community-dwelling cognitively normal elderly persons, 70 DLB patients, and 70 AD patients with collateral informants. A 19-item questionnaire was administered to the informants that queried about symptoms of fluctuations and delirium.

Results: Fluctuations occur infrequently in nondemented elderly persons aged 58 to 98 years. In contrast, four characteristics of fluctuations were found to significantly differentiate AD from DLB. These composite features include daytime drowsiness and lethargy, daytime sleep of 2 or more hours, staring into space for long periods, and episodes of disorganized speech. The presence of three or four features of this composite occurred in 63% of DLB patients compared with 12% of AD patients and 0.5% of normal elderly persons. Informant endorsement of three or four of these items yielded a positive predictive value of 83% for the clinical diagnosis of DLB against an alternate diagnosis of AD. Endorsement of fewer than three items had a negative predictive value of 70% for the absence of a clinical diagnosis of DLB in favor of AD. The authors present evidence of test-retest reliability, convergent validity, and empirical verification with a separate cross-validation sample. Fluctuations were not associated with any particular combination of hallucinations, parkinsonism, or REM sleep behavior disorder.

Conclusions: Based on informant report, disturbed arousal and disorganized speech are specific aspects of fluctuations in dementia with Lewy bodies that reliably distinguish dementia with Lewy bodies from Alzheimer’s disease and normal aging.

PubMed ID #: 14745051 (see pubmed.gov for this abstract only)

“40 Years Later, Still No Cure” (for PD), Washington Post Article 3/4/07

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This is a thought-provoking article from the Washington Post about there still not being a cure for Parkinson’s Disease (PD), despite the fact that we’ve seen forty years of research.

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/02/AR2007030202034.html

40 Years Later, Still No Cure
The Washington Post
By Phyllis Richman
Sunday, March 4, 2007

Happy reading,
Robin