Thesis

Frontotemporal dementia recognizing patterns of cognitive performance in relation to activities of daily living

Dementia represents a series of degenerative diseases known to cause a decline in cognitive functioning. A significant yet understudied type of dementia is frontotemporal dementia (FTD), characterized primarily by deficits in executive abilities and language. There is, particularly, little data regarding the daily functional abilities of FTD patients. The current study aimed to detail patterns of activities of daily living, using an observation-based test, and neuropsychological performance of patients with FTD. Thirteen participants with FTD were administered the Direct Assessment of Functional Status (DAFS). Fourteen subscales of the DAFS, designed to assess areas of orientation, communication, transportation, shopping, and financial skills were assessed. Each task within the subscales is observed and rated objectively by the researcher who scores participants on their performance; higher scores are equivalent to better performance. DAFS subscale scores were then converted to percentage correct responses for each subscale. FTD and 57 normal age and education-matched controls also completed a battery of cognitive tests designed to assess major cognitive domains, which included the Digit Span, CVLT, WCST, FAS and Rey-O. FTD patients' raw neuropsychological test scores were converted to z-scores using control participants' mean and standard deviation measures in order to create comparable units of measurement. The results revealed no significant differences between the neuropsychological z-scores for the FTD. However, a significant difference in ADL performance across groups, with NC outperforming those with FTD on nearly all areas of ADL performance was found. Within group analyses revealed that tasks related to recall, recognition and executive functioning were particularly difficult for those with FTD. Overall results support prior research in stating that those with FTD will be outperformed by normal controls on tasks related to ADL functioning. However, what this study specifically identifies is that within the range of deficits characterized through the DAFS scores, there are areas of ADL performance which are significantly more challenging for those with FTD in relation to not only age matched controls, but within their own patterns of deficits.

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