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Frontal Behavioral Syndromes in Cortical and Subcortical Dementia

University of California, San Diego San Diego Department of Veterans Affairs Medical Center

Julie C. Stout

Indiana University

Jody DeLaPena

University of California, San Diego

Ramon Romero

University of California, San Diego

Zeena Tawfik-Reedy

University of California, San Diego

Michael R. Swenson

University of California, San Diego

Janet Grace

Memorial Hospital of Rhode Island Brown University School of Medicine

Paul F. Malloy

Brown University School of Medicine

Butler Hospital

Brown University School of Medicine

The Frontal Lobe Personality Scale (FLOPS; Grace & Malloy, 1992) was administered to the caregivers of 51 patients with neurodegenerative disease to examine personality and behavioral features associated with prototypical "cortical" dementia (i.e., Dementia of the Alzheimer Type; DAT) and "subcortical" dementia (i.e., Huntington's disease; HD). The FLOPS is a 45-item behavior rating scale designed to identify three frontal syndromes: (a) apathy, (b) disinhibition, and (c) executive dysfunction.

Comparing subgroups of HD and DAT that were matched for age and dementia severity (ns = 12), the HD subgroup had higher FLOPS apathy ratings. Using all patients, FLOPS ratings were associated with traditional neuropsychological measures as well as a measure of everyday functioning.

Discriminant function analyses, accurately classified over 92% of the DAT patients and nearly 77% of the HD patients, which is consistent with the discriminative utility of other traditional neuropsychological tests. These data suggest that informant-based ratings of so-called "frontal lobe" behaviors may be a useful adjunct to current neuropsychological evaluations in an attempt to characterize personality changes that co-occur with neurodegenerative disease.

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