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Original Research Article

When a Little Knowledge Can Be Dangerous: False-Positive Diagnosis of Behavioral Variant Frontotemporal Dementia among Community Clinicians

Shinagawa S.a, b · Catindig J.A.a, c · Block N.R.a · Miller B.L.a · Rankin K.P.a

Author affiliations

aMemory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, Calif., USA; bDepartment of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan; cDepartment of Neurology and Psychiatry, University of Santo Tomas, Manila, Philippines

Related Articles for ""

Dement Geriatr Cogn Disord 2016;41:99-108

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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: July 08, 2015
Published online: January 08, 2016
Issue release date: March 2016

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 2

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM

Abstract

Background: Accurate diagnosis of behavioral variant frontotemporal dementia (bvFTD) is important as patients' behavioral symptoms have profound implications for their families and communities. Since the diagnosis of bvFTD derives from behavioral features, accurate identification of patients can be difficult for non-specialists. Concrete rates of diagnostic accuracy among non-specialists are unavailable. Methods: To examine the accuracy of community clinicians' diagnoses of bvFTD and to identify patient characteristics leading to misdiagnosis, we reviewed the charts and referral letters of 3,578 patients who were seen at our specialized center. Referral diagnosis and reasons, manifesting symptoms, demographic data, Mini-Mental State Examination score, Clinical Dementia Rating score and Neuropsychiatric Inventory score were extracted. Results: 60% of patients assigned a single diagnosis of bvFTD by community clinicians did not have bvFTD according to specialists. Compared to specialist-confirmed bvFTD patients, false bvFTD patients were more likely to be depressed and to be non-Caucasian, showed less euphoria, apathy, disinhibition and abnormal eating behaviors, had milder disease severity and better overall cognition. bvFTD was mentioned by referring clinicians in 86% of specialist-confirmed bvFTD cases, but missed cases were called Alzheimer's, Parkinson's or Huntington's disease, or progressive aphasia. Conclusion: These results revealed a widespread lack of familiarity with core diagnostic symptoms among non-specialists and suggest that community clinicians require specialized diagnostic support before providing a definitive diagnosis of bvFTD.

© 2016 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: July 08, 2015
Published online: January 08, 2016
Issue release date: March 2016

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 2

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


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