Comparing clinical features of behavioral variant frontotemporal dementia and Alzheimer's disease using network analysis

Abstract

INTRODUCTION: Clinical characterization of behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) is challenging due to overlapping neuropsychiatric symptoms and cognitive profiles between the two conditions. METHODS: We used clinical network analysis to characterize and compare clinical profiles in AD and bvFTD using initial visit data from the National Alzheimer's Coordinating Center. RESULTS: The final matched sample included 890 patients per group (AD: mean age = 63.02, standard deviation [SD] = 9.34, 36.4% female; bvFTD: mean age = 62.87, SD = 9.46, 36.52% female). Both networks were densely connected, reflecting comorbidity between neuropsychiatric symptoms and cognitive scores. Memory performance, hallucinations, and motor disturbance were bridge symptoms in the AD network, whereas elation was the sole bridge symptom in the bvFTD network. DISCUSSION: Distinct networks highlight unique clinical profiles in AD and bvFTD. Treatment of bridge symptoms may relieve overall symptom burden. Findings can advance clinical characterization of AD and bvFTD, leading to development of targeted interventions. Highlights: We compared clinical features of Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Clinical networks showed comorbidity between neuropsychiatric symptoms and cognitive manifestations. Clinical networks significantly differed between AD and bvFTD, highlighting unique behavioral and cognitive profiles. Distinct symptoms were important for overall symptom comorbidity. Findings can be used to characterize AD and bvFTD and inform targeted treatment.