Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels
Background: The behavioral variant of frontotemporal dementia (bvFTD), characterized by early behavioral abnormalities and late memory impairment, is a neurodegenerative disorder with a detrimental impact on patients and their caregivers. bvFTD is often difficult to distinguish from other neurodegen...
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.704109/full |
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| author | Nilton Custodio Nilton Custodio Nilton Custodio Rosa Montesinos Rosa Montesinos Rosa Montesinos Lizardo Cruzado Lizardo Cruzado Lizardo Cruzado Eder Herrera-Perez Eder Herrera-Perez Eder Herrera-Perez Virgilio E. Failoc-Rojas Virgilio E. Failoc-Rojas Maritza Pintado-Caipa Maritza Pintado-Caipa Maritza Pintado-Caipa Maritza Pintado-Caipa Wendy Seminario G Wendy Seminario G Wendy Seminario G José Cuenca José Cuenca José Cuenca José Cuenca Carlos Gamboa Carlos Gamboa Carlos Gamboa Monica M. Diaz Monica M. Diaz |
| author_facet | Nilton Custodio Nilton Custodio Nilton Custodio Rosa Montesinos Rosa Montesinos Rosa Montesinos Lizardo Cruzado Lizardo Cruzado Lizardo Cruzado Eder Herrera-Perez Eder Herrera-Perez Eder Herrera-Perez Virgilio E. Failoc-Rojas Virgilio E. Failoc-Rojas Maritza Pintado-Caipa Maritza Pintado-Caipa Maritza Pintado-Caipa Maritza Pintado-Caipa Wendy Seminario G Wendy Seminario G Wendy Seminario G José Cuenca José Cuenca José Cuenca José Cuenca Carlos Gamboa Carlos Gamboa Carlos Gamboa Monica M. Diaz Monica M. Diaz |
| author_sort | Nilton Custodio |
| collection | DOAJ |
| description | Background: The behavioral variant of frontotemporal dementia (bvFTD), characterized by early behavioral abnormalities and late memory impairment, is a neurodegenerative disorder with a detrimental impact on patients and their caregivers. bvFTD is often difficult to distinguish from other neurodegenerative diseases, such as Alzheimer's disease (AD), using brief cognitive tests. Combining brief socio-cognitive and behavioral evaluations with standard cognitive testing could better discriminate bvFTD from AD patients. We sought to evaluate the diagnostic accuracy of brief socio-cognitive tests that may differentiate bvFTD and AD patients with low educational levels.Methods: A prospective study was performed on 51 individuals over the age of 50 with low educational levels, with bvFTD or AD diagnosed using published criteria, and who were receiving neurological care at a multidisciplinary neurology clinic in Lima, Peru, between July 2017 and December 2020. All patients had a comprehensive neurological evaluation, including a full neurocognitive battery and brief tests of cognition (Addenbrooke's Cognitive Examination version III, ACE-III), social cognition (Mini-social Cognition and Emotional Assessment, Mini-SEA), and behavioral assessments (Frontal Behavioral Inventory, FBI; Interpersonal Reactivity Index—Emphatic Concern, IRI-EC; IRI—Perspective Taking, IRI-PT; and Self-Monitoring Scale—revised version, r-SMS). Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was performed to compare the brief screening tests individually and combined to the gold standard of bvFTD and AD diagnoses.Results: The AD group was significantly older than the bvFTD group (p < 0.001). An analysis of the discriminatory ability of the ACE-III to distinguish between patients with AD and bvFTD (AUC = 0.85) and the INECO Frontal Screening (IFS; AUC = 0.78) shows that the former has greater discriminatory ability. Social and behavioral cognition tasks were able to appropriately discriminate bvFTD from AD. The Mini-SEA had high sensitivity and high moderate specificity (83%) for discriminating bvFTD from AD, which increased when combined with the brief screening tests ACE-III and IFS. The FBI was ideal with high sensitivity (83%), as well as the IRI-EC and IRI-PT that also were adequate for distinguishing bvFTD from AD.Conclusions: Our study supports the integration of socio-behavioral measures to the standard global cognitive and social cognition measures utilized for screening for bvFTD in a population with low levels of education. |
| first_indexed | 2024-12-17T22:55:52Z |
| format | Article |
| id | doaj.art-4f2691429ce8475bb687554599d5bd61 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-17T22:55:52Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4f2691429ce8475bb687554599d5bd612022-12-21T21:29:33ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-09-011210.3389/fneur.2021.704109704109Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational LevelsNilton Custodio0Nilton Custodio1Nilton Custodio2Rosa Montesinos3Rosa Montesinos4Rosa Montesinos5Lizardo Cruzado6Lizardo Cruzado7Lizardo Cruzado8Eder Herrera-Perez9Eder Herrera-Perez10Eder Herrera-Perez11Virgilio E. Failoc-Rojas12Virgilio E. Failoc-Rojas13Maritza Pintado-Caipa14Maritza Pintado-Caipa15Maritza Pintado-Caipa16Maritza Pintado-Caipa17Wendy Seminario G18Wendy Seminario G19Wendy Seminario G20José Cuenca21José Cuenca22José Cuenca23José Cuenca24Carlos Gamboa25Carlos Gamboa26Carlos Gamboa27Monica M. Diaz28Monica M. Diaz29Servicio de Neurología, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruFacultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruInstituto Nacional de Salud Mental “Honorio Delgado—Hideyo Noguchi”, Lima, PeruGrupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruServicio de Neurología, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruAtlantic Fellow, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United StatesServicio de Neurología, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruFacultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, PeruServicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru0Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, PeruUnidad de Diagnóstico de Deterioro Cognitivo y Prevención De Demencia, Instituto Peruano de Neurociencias, Lince, PeruUnidad de Investigación, Instituto Peruano de Neurociencias, Lince, PeruServicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru1Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States2Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, PeruBackground: The behavioral variant of frontotemporal dementia (bvFTD), characterized by early behavioral abnormalities and late memory impairment, is a neurodegenerative disorder with a detrimental impact on patients and their caregivers. bvFTD is often difficult to distinguish from other neurodegenerative diseases, such as Alzheimer's disease (AD), using brief cognitive tests. Combining brief socio-cognitive and behavioral evaluations with standard cognitive testing could better discriminate bvFTD from AD patients. We sought to evaluate the diagnostic accuracy of brief socio-cognitive tests that may differentiate bvFTD and AD patients with low educational levels.Methods: A prospective study was performed on 51 individuals over the age of 50 with low educational levels, with bvFTD or AD diagnosed using published criteria, and who were receiving neurological care at a multidisciplinary neurology clinic in Lima, Peru, between July 2017 and December 2020. All patients had a comprehensive neurological evaluation, including a full neurocognitive battery and brief tests of cognition (Addenbrooke's Cognitive Examination version III, ACE-III), social cognition (Mini-social Cognition and Emotional Assessment, Mini-SEA), and behavioral assessments (Frontal Behavioral Inventory, FBI; Interpersonal Reactivity Index—Emphatic Concern, IRI-EC; IRI—Perspective Taking, IRI-PT; and Self-Monitoring Scale—revised version, r-SMS). Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was performed to compare the brief screening tests individually and combined to the gold standard of bvFTD and AD diagnoses.Results: The AD group was significantly older than the bvFTD group (p < 0.001). An analysis of the discriminatory ability of the ACE-III to distinguish between patients with AD and bvFTD (AUC = 0.85) and the INECO Frontal Screening (IFS; AUC = 0.78) shows that the former has greater discriminatory ability. Social and behavioral cognition tasks were able to appropriately discriminate bvFTD from AD. The Mini-SEA had high sensitivity and high moderate specificity (83%) for discriminating bvFTD from AD, which increased when combined with the brief screening tests ACE-III and IFS. The FBI was ideal with high sensitivity (83%), as well as the IRI-EC and IRI-PT that also were adequate for distinguishing bvFTD from AD.Conclusions: Our study supports the integration of socio-behavioral measures to the standard global cognitive and social cognition measures utilized for screening for bvFTD in a population with low levels of education.https://www.frontiersin.org/articles/10.3389/fneur.2021.704109/fullsocial cognitionbehavioral scalesfrontotemporal dementialow educationscreening |
| spellingShingle | Nilton Custodio Nilton Custodio Nilton Custodio Rosa Montesinos Rosa Montesinos Rosa Montesinos Lizardo Cruzado Lizardo Cruzado Lizardo Cruzado Eder Herrera-Perez Eder Herrera-Perez Eder Herrera-Perez Virgilio E. Failoc-Rojas Virgilio E. Failoc-Rojas Maritza Pintado-Caipa Maritza Pintado-Caipa Maritza Pintado-Caipa Maritza Pintado-Caipa Wendy Seminario G Wendy Seminario G Wendy Seminario G José Cuenca José Cuenca José Cuenca José Cuenca Carlos Gamboa Carlos Gamboa Carlos Gamboa Monica M. Diaz Monica M. Diaz Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels Frontiers in Neurology social cognition behavioral scales frontotemporal dementia low education screening |
| title | Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels |
| title_full | Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels |
| title_fullStr | Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels |
| title_full_unstemmed | Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels |
| title_short | Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels |
| title_sort | social cognition and behavioral assessments improve the diagnosis of behavioral variant of frontotemporal dementia in older peruvians with low educational levels |
| topic | social cognition behavioral scales frontotemporal dementia low education screening |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.704109/full |
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