A-64: Neuropsychological Predictors for Behavioral Variant Frontotemporal Dementia Using the NACC Uniform Data Set
Abstract
Objective: To determine whether core behavioral symptoms (apathy, disinhibition, and appetite/eating disturbance) measured by the NPI-Q, along with neuropsychological performance, differentiate individuals with behavioral variant frontotemporal dementia (bvFTD) from non-bvFTD participants, and to examine how these symptoms relate to cognitive functioning within bvFTD. Method/Data Selection: Data from the National Alzheimer’s Coordinating Center (N = 56,034; 3,970 bvFTD) were analyzed. Hierarchical logistic regression predicted bvFTD status from NPI-Q behavioral symptoms (apathy, disinhibition, appetite/eating disturbance), controlling for age, sex, and education. Cognitive measures included the Trail Making Test Part B, animal/phonemic fluency, and Digit Span Backward, allowing evaluation of behavioral predictors relative to executive-function performance. Results/Data Synthesis: NPI-Q symptoms strongly differentiated bvFTD from non-bvFTD (χ2(6) = 6358.63, p < .001), with disinhibition showing the strongest effect, followed by apathy and appetite/eating disturbance (all ps < .001). Younger age, male sex, and higher education also predicted bvFTD. Within bvFTD, disinhibition was associated with better performance on Trail B, fluency tasks, and Digit Span Backward (all ps ≤ .018), while apathy and appetite disturbance were linked only to lower phonemic fluency (ps = .017). Symptoms remained significant after demographic adjustment (χ2 = 2336.23, p < .001). After controlling for the demographic variables, the key symptoms (i.e., apathy, disinhibition, and appetite) as a whole significantly predicted diagnosis (χ2 2336.230, ps<.001). Conclusions: Behavioral symptoms, particularly disinhibition, effectively differentiate bvFTD from non-bvFTD individuals, supporting their central role in diagnosis. Cognitive measures showed more limited and variable associations. These findings highlight the importance of behavioral assessment in identifying bvFTD and underscore the heterogeneity of its clinical presentation.