Validity and Reliability of the Frontotemporal Dementia Rating Scale (FTD-FRS) for the Progression and Staging of Dementia in Brazilian Patients

Introduction: Few studies on instruments for staging frontotemporal dementia (FTD) have been conducted.  Objective: The objective of this study was to analyze the factor structure, internal consistency, reliability, and convergent validity of the Brazilian version of the Frontotemporal Dementia Rating Scale (FTD-FRS).  Methods: A total of 97 individuals aged 40 years and above with >2 years’ education took part in the study, 31 patients diagnosed with behavioral variant FTD (bvFTD), 8 patients with primary progressive aphasia, 28 with Alzheimer disease, 8 with mild cognitive impairment, and a control group of 22 healthy subjects. The FTD-FRS was completed by family members or caregivers, and Neurologists completed the 8-item Clinical Dementia Rating for Frontotemporal Lobar Degeneration (CDR-FTLD) scale (6 original domains plus Language and Behavior). The Alzheimer disease and FTD patients had equivalent disease severity level.  Results: The internal consistency of the FTD-FRS, estimated by Cronbach α, was 0.975 whereas test-retest reliability was 0.977. Scree plot and exploratory factor (Varimax rotation) analyses revealed the existence of 4 factors, with eigenvalues >1, which together explained 77.13% of the total variance with values of 1.28 to 17.52. The domains of the Brazilian version of the FTD-FRS scale correlated with the domains of the CDR-FTLD.  Conclusions: The present study is the first to document the factorial structure of the FTD-FRS and its convergent validity with the CDR-FTLD. These tools are key to determine dementia severity in FTD. The Brazilian FTD-FRS demonstrated adequate psychometric properties for use in Brazil. This instrument may contribute to disease staging in FTD and may help to document intervention-related changes

Caracterização clínica da demência vascular: avaliação retrospectiva de uma amostra de pacientes ambulatoriais

OBJETIVO: analisar as características clínicas e as condições mórbidas (CM) associados em uma amostra de pacientes com demência vascular (DV). MÉTODOS: foram estudados retrospectivamente 25 pacientes com diagnóstico de DV, estabelecidos com base critérios do grupo State of California Alzheimer´s Disease Diagnostic and Treatment Centers (ADDTC). Os dados clínicos e de neuroimagem e os exames laboratoriais foram computados para caracterização da amostra. RESULTADOS: a média da faixa etária foi de 68,7 ± 14,6 anos (64,0% homens), com escolaridade média de 5,2 ± 4,4 anos. A instalação súbita do quadro foi observada em 48,0% dos pacientes e a evolução em degraus e o curso flutuante, em 4,0% e 16,0% dos casos, respectivamente. Apresentavam déficit neurológico focal como sintoma inicial 48,0%, sendo constatado déficit ao exame em 80,0%. As principais CM foram: hipertensão arterial sistêmica (92,0%); hipercolesterolemia (64,0%); insuficiência coronariana (40,0%); tabagismo (40,0%); hipertrigliceridemia (36,0%); diabete melito (32,0%); doença de Chagas (8,0%). CONCLUSÕES: observou-se forte correlação entre DV e hipertensão e hipercolesterolemia. A presença de dois pacientes com doença de Chagas sugere que esta doença possa constituir possível fator de risco regional

Monoamine Oxidase A Polymorphism in Brazilian Patients Risk Factor for Late-Onset Alzheimer's Disease?

Abstract Different studies have attempted to find polymorphisms involved in the serotonergic pathway that could be involved in mood disorders and late-onset Alzheimer's disease (LOAD) symptoms. Here, we compared the frequency of two polymorphisms: monoamine oxidase A (MAOA) and serotonin transporter in LOAD patients versus controls. No evidence of association was observed when these polymorphisms were compared separately; however, the combination of the MAOA allele 1 + the short allele of 5-HTTLPR + ApoE-ε4 was significantly more frequent in patients than in controls. It reinforces the hypothesis that different genes acting together might play a role in AD susceptibility. Based on these data, we suggest replicating these studies in larger samples of LOAD patients belonging to different ethnic groups

Brazilian version of the Mattis dementia rating scale: diagnosis of mild dementia in Alzheimer's disease Versão brasileira da escala de avaliação de demência de Mattis: diagnóstico de demência leve na doença de Alzheimer

OBJECTIVES: To verify the diagnostic accuracy of the Brazilian version of the Mattis Dementia Rating Scale (DRS) in the diagnosis of patients with mild dementia in Alzheimer's disease (AD); to verify the interference of the variables age and schooling on the performance of the DRS. METHOD: The DRS was administered to 41 patients with mild AD and to 60 controls. In order to analyze the effects of age and schooling on the performance of the tests, patients and controls were separated into three age groups and three levels of schooling. RESULTS: The cutoff score of 122 showed a sensitivity of 91.7 % and specificity of 87.8 %. Age and schooling interfered in the DRS total score and in the scores of its subscales. CONCLUSION: The DRS showed good diagnostic accuracy in the discrimination of patients with mild AD from the control individuals. In the sample examined, the effects of schooling were more marked than age.<br>OBJETIVO: Verificar a acurácia diagnóstica da versão brasileira da Escala de Avaliação de Demência (DRS) no diagnóstico de pacientes com doença de Alzheimer (DA) leve; verificar a interferência das variáveis idade e escolaridade no desempenho da DRS. MÉTODO: A DRS foi aplicada em 41 pacientes com DA provável, de intensidade leve, e em 60 controles. Para análise das variáveis idade e escolaridade, pacientes e controles foram divididos em três grupos de idade e em três níveis de escolaridade. RESULTADOS: A nota de corte 122 demonstrou sensibilidade de 91,7% e especificidade de 87,8%. Idade e escolaridade interferiram no escore total e nos escores das subescalas da DRS. CONCLUSÃO: A DRS demonstrou boa acurácia diagnóstica na discriminação entre pacientes com DA leve e indivíduos controles. Na população estudada, os efeitos da escolaridade foram mais acentuados que os da idade