CLINICAL-DIAGNOSIS OF FRONTOTEMPORAL DEME NTIA

Frontotemporal dementia (FTD) is poorly recognized clinically. Of the 1, 517 patients examined at the Lille Outpatients Memory Clinic data b ank (1991-1995), 74 fulfilled the criteria of the Lund and Manchester groups for FTD. They accounted for 5p. 100 of all patients, 7 for 10 p robable or possible Alzheimer's disease. Mean patient age was 63 years , duration of the disease was 5 years, mean Mini Mental State score wa s 23; 45 p. 100 belonged to the active population. Behavioral disorder s occurred before the cognitive decline and remained the major feature . All patients had at least 3 of the following symptoms: self-control impairment, affective disorder, loss of interest and self-neglect Memo ry impairment consisted of correct encoding and impaired retrieval pro cesses, without major storage impairment No patients had spatial disor ientation. Language was usually reduced. EEG was normal. Two diagnoses were confirmed by autopsy: both consisted of aspecific frontal and te mporal degeneration. 41 p. 100 of the patients were referred by a gene ral practioner, 30 p. 100 by a psychiatrist, 16 p. 100 by a neurologis t, 2 p. 100 by other specialists, and 11 p. 100 following the advice o f their relatives. FTD had never been suspected. Alzheimer's disease o r non specified degenerative dementia was suspected in 2/3 of patients and a psychiatric disorder in 1/3. With the advent of novel pharmacol ogical agents for the treatment of dementing disorders and for researc h purposes the identification and accurate differentiation of FTD from Alzheimer's disease and pschiatric disorder is essential. Therefore, the role of multidisciplinary memory clinic is crucial to differentiat e FTD from other degenerative dementias.