Instrumental activities of daily living in clinical subtypes of frontotemporal dementia (P2.081)

Objective: Compare patterns and cognitive/behavioral correlates of functional deficits across clinical subtypes of frontotemporal dementia. Background: Previous work examining activities of daily living (ADLs) in frontotemporal dementia (FTD) suggests that behavioral variant FTD (bvFTD) is characterized by greater functional deficits than non-fluent/agrammatic variant primary progressive aphasia (nfvPPA) or semantic variant primary progressive aphasia (svPPA). However, it remains uncertain if these FTD subtypes exhibit different patterns and/or cognitive and behavioral correlates of functional decline. Design/Methods: We examined cross-sectional functional, cognitive, and behavioral data in the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS) from participants diagnosed with bvFTD (n=607), nfvPPA (n=155), and svPPA (n=132) who were assessed on instrumental ADLs with the Functional Activities Questionnaire (FAQ). Results: After adjusting for demographic factors and symptom duration, significantly higher total FAQ scores (i.e. greater deficits) were seen in bvFTD relative to nfvPPA and svPPA. Higher scores on each individual FAQ item were seen in bvFTD relative to nfvPPA; individual item scores in svPPA fell between the other two groups. FAQ scores significantly correlated with behavioral, memory, and processing speed/executive indices in the bvFTD and nfvPPA groups and with behavioral and processing speed/executive indices in the svPPA group. In the subset of bvFTD participants assessed with social cognition indices from the NACC FTLD module, higher FAQ scores correlated with lower scores on the Revised Self-Monitoring Scale. Conclusions: Our findings confirm that functional impairments differ in severity across FTD subtypes, as more profound deficits were seen in bvFTD relative to nfvPPA and svPPA, but not in pattern. Instrumental ADL deficits are associated with poorer executive function, more severe behavioral symptoms, and impaired self-awareness, but not with language difficulties. Interventions targeting behavioral pathology may improve functional outcomes in FTD. Study Supported by: This research was supported by the Alzheimer’s Disease Research Centers of California and the Sidell-Kagan Foundation. The NACC database is funded by NIA/NIH Grant U01 AG016976. Disclosure: Dr. Moheb has nothing to disclose. Dr. Mendez has received personal compensation in an editorial capacity for UpToDate. Dr. Kremen has nothing to disclose. Dr. Teng’s spouse holds stock and/or stock options in GE Healthcare and Cerner Corporation.