Alzheimer Disease: Förstl H

Förstl H. · No affiliation provided · Int Psychogeriatr. · Pubmed #18413000 No free full text.

This publication has no abstract.

Förstl H. · No affiliation provided · Int Psychogeriatr. · Pubmed #12834196 No free full text.

This publication has no abstract.

Förstl H. · No affiliation provided · Int Psychogeriatr. · Pubmed #11352332 No free full text.

This publication has no abstract.

Förstl H, Werheid K, Ulm K, Schönknecht P, Schmidt R, Pantel J, Hörr R, Gutzmann H, Gertz HJ, Frölich L, Bickel H. · Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München. · Dtsch Med Wochenschr. · Pubmed #19142839 No free full text.

Abstract: Long-term studies will be pivotal in order to examine the efficacy of preventive and early therapeutic interventions during the preclinical phase of dementia. Biomarkers will be of importance due to the large sample sizes and the necessary logistic efforts, high drop-out rates and slow clinical progression. The validity of functional and even structural imaging methods is currently investigated with early and promising results; it is presently unclear whether conventional csf-markers of Alzheimer's disease (beta-amyloid and tau-proteins) are sufficiently sensitive to monitor the effects of early interventions. It also remains doubtful whether modifications of these methods will ever be useful and available for practical purposes.

Nieoullon A, Bentué-Ferrer D, Bordet R, Tsolaki M, Förstl H. · Université de la Méditerranée, Institut de Biologie du Développement de Marseille-Luminy, Marseille, France. · Curr Med Res Opin. · Pubmed #19032118 No free full text.

Abstract: OBJECTIVE AND SCOPE: This review article used data from an extensive literature search (including MEDLINE database searches) to explore the relationships between sleep, memory and Alzheimer's disease (AD). The importance of taking into account circadian rhythmicity and acetylcholine (ACh) levels when considering acetylcholinesterase inhibitors, galantamine in particular, in the treatment of patients with AD is discussed. REVIEW FINDINGS: Moderate changes of circadian rhythms may occur as part of the normal ageing process, but patients with AD exhibit circadian rhythm disturbances extending beyond those observed in non-demented elderly and this may lead to severe disruption of the sleep-wake cycle. Indeed, ACh plays an active role in maintaining a normal sleep pattern, which is important for memory consolidation. Low levels of ACh during slow-wave sleep compared with wakefulness have been shown to be critical for the consolidation of declarative memory. This suggests the existence of a circadian rhythm in central cholinergic transmission which modulates memory processes, with high ACh levels during wakefulness and reduced levels during slow-wave sleep. When using cholinesterase inhibitors to stimulate central cholinergic transmission in AD, respecting the natural circadian fluctuations of central cholinergic transmission may therefore be an important factor for patient improvement. Interfering with nocturnal cholinergic activity can add to memory problems and induce sleep disorders. Available data suggest that the type of cholinesterase inhibitor used and the time of administration may be critical with regard to the possible development of such disturbances. Plasma levels of galantamine, for example, are high during the waking day and lower at night, supporting a cholinergic stimulation that mirrors the physiological circadian rhythm of cholinergic activity. This may have beneficial implications with regard to sleep and memory. Conclusions: The pharmacokinetic properties of cholinesterase inhibitors may need to be taken into account to avoid interference with sleep architecture and to achieve optimum benefits from treatment on cognitive processes.

Gratz S, Hahn U, Kaiser JW, Jarnig M, Schwarz J, Förstl H. · Praxis für Nuklearmedizin und Radiologie, Stuttgart Bad Cannstatt. · Dtsch Med Wochenschr. · Pubmed #18437639 No free full text.

Abstract: Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are important tools in the differential diagnosis and therapeutic monitoring of cognitive disorders. SPECT and PET are highly sensitive methods for the early diagnosis of underlying neurodegeneration and the functional changes in the basal ganglia. Early and reliable diagnosis will become even more relevant with the development of options in the causal treatment of dementias, which would exert their most beneficial effects well before the onset of clinical symptoms. This review provides a brief survey on currently available methods of nuclear imaging in cortical (Alzheimer's disease) and subcortical forms of neurodegenerative dementia (Parkinson's disease; dementia with Lewy bodies).

Förstl H. · Klinik & Poliklinik für Psychiatrie & Psychotherapie, TU München, Ismaningerstrasse 22, Munich, Germany. · Nervenarzt. · Pubmed #18385970 No free full text.

Abstract: The majority of elderly demented patients suffers from mixed dementia, with Alzheimer's-type brain changes being the leading cause of cognitive impairment. Cholinesterase inhibitors and memantin improve cognitive performance in dementia, with a symptomatic parallel shift of 8 to 12 months. Disturbances of perception and behaviour can be prohibited or mitigated by antidementia drugs and improved with antidepressants, neuroleptics, and other substances. The somatic and cerebral comorbidity of demented patients offers further options for improving sensory input, cerebral availability of oxygen and glucose, and even secondary prevention. Technical support systems for demented patients which are already available remain largely underused. Psychosocial support is mandatory, even though the advantages of specific interventions have not been demonstrated with scientific rigour.

Lautenschlager NT, Förstl H. · School of Psychiatry and Clinical Neurosciences and WA Centre for Health and Ageing, University of Western Australia, Australia. · Curr Opin Psychiatry. · Pubmed #17143085 No free full text.

Abstract: PURPOSE OF REVIEW: The present short review summarizes some of the most important personality changes in older adults. RECENT FINDINGS: Personality changes in old age are usually minimal. Cluster B personality disorders appear to become less prevalent. Significant changes in personality are typically associated with frontotemporal lobar degeneration (e.g., slowly progressive sociopathy), Alzheimer's disease, mild cognitive impairment due to incipient dementia or underlying medical illness. SUMMARY: Therefore, we suggest that a significant change in personality in old age always warrants careful neuropsychiatric examination.

Birkhofer A, Schmidt G, Förstl H. · Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar der Technischen Universität München. · Fortschr Neurol Psychiatr. · Pubmed #15806437 No free full text.

Abstract: Psychiatric disorders are associated with autonomic dys-regulations. There is evidence that these dys-regulations are partly responsible for the increased mortality in patients with psychiatric disorders. The determination of the heart rate variability (HRV) is a method easily applicable and allows the assessment of the autonomic control of the heart rate regulation. A multitude of HRV parameters with different physiological meanings have been introduced, the most widely used parameters are presented and characterized in this paper. Many studies have shown a reduced HRV in patients with major depression. Most studies found a reduced parasympathetic activity. However some authors discuss an elevated sympathetic activity. The magnitude of HRV reduction correlates to the severity of the depression. In patients with coronary diseases, major depression is an independent risk factor of mortality. Antidepressive therapy with serotonin reuptake inhibitors has failed to improve the prognosis of this patients. Patients with panic disorders also have a reduced HRV due to an elevated sympathetic control and reduced vagal control. In schizophrenic patients a reduced HRV was found in long term electrocardiogram recordings, whereas short term recordings did not show a reduced HRV. Patients with Alzheimer's disease also have a reduced HRV, which is limited to the low frequency component. Therapy with cholinesterase inhibitors further influences HRV by reducing the high frequency component and might increase the risk for arrhythmias. HRV analysis and integration in the assessment and monitoring of psychiatric patients before and during therapy elucidate the role of autonomic disturbances in such diseases and may help to optimize treatment.

Frölich L, Schmitt B, Calabrese P, Diener H, Förstl H, Gertz HJ, Hallauer JF, Hampel H, Ihl R, Rieke K, Riepe M, Supprian T. · Zentralinstitut für Seelische Gesundheit Mannheim, Universität Heidelberg. · Dtsch Med Wochenschr. · Pubmed #15717252 No free full text.

This publication has no abstract.

Diehl J, Förstl H, Jansen S, Kurz A. · Klinik und Poliklinik für Psychiatrie der TU München, Ismaninger Str. 22, 81675 München, Germany. · Z Gerontol Geriatr. · Pubmed #15338159 No free full text.

Abstract: Frontotemporal dementia is a relatively rare neurodegenerative disease. In the majority of cases the onset is at a presenile age, and changes of behavior as well as alterations of personality and social conduct are predominant symptoms whereas cognitive deficits are mild. Therefore interventions for caregivers including self-help groups and educational programs which are usually tailored to Alzheimer's disease often do not meet the needs of caregivers of patients with FTD. The present paper reviews the clinical features of FTD, outlines the specific problems and burdens that caregivers are faced with, and describes novel interventions for this group of family caregivers.

Förstl H. · Department of Psychiatry and Psychotherapy, Technical University Munich, Klinikum rechts der Isar, Germany. · Eur Arch Psychiatry Clin Neurosci. · Pubmed #10654102 No free full text.

Abstract: In 1923, Friedrich H. Lewy described dementia with Lewy bodies in a large proportion of his patients with paralysis agitans which had co-incident plaques and neurofibrillary tangles. The potential contribution of Lewy bodies to a dementia syndrome with fluctuating course, visual hallucinations, Parkinsonian features and neuroleptic hypersensitivity was rediscovered many decades later. The comorbidity of Alzheimer's and Parkinson's disease is not uncommon as both diseases show an exponential increase with advancing age and their coincidence is of great clinical importance. The combination of a cholinergic deficit--which is particularly severe due to the double pathology targeting the basal nucleus of Meynert--and a dopaminergic deficit requires cholinergic and cautious dopaminergic treatment. Excessive dopamine (L-dopa), antidopaminergic (neuroleptic) or anticholinergic treatment (anti-Parkinson or neuroleptic medication) may further complicate the condition, worsen extrapyramidal, psychotic or cognitive disturbances and even lead to a neuroleptic malignant syndrome.

Förstl H, Kurz A. · Department and Clinic of Psychiatry and Psychotherapy, TU Munich. · Eur Arch Psychiatry Clin Neurosci. · Pubmed #10653284 No free full text.

Abstract: The preclinical stage of Alzheimer's disease is inconspicuous and there are - almost by definition - no reliable and valid symptoms and signs which would allow a very early diagnosis before the manifestation of irreversible deficits. For a clinical diagnosis of dementia, cognitive impairment has to be severe enough to compromise the activities of daily living. In the mild dementia stage, difficulties with declarative memory are usually prominent; depressive symptoms are not infrequent, but the patient usually manages to live alone. Supervision is needed in the moderate dementia stage, when other cognitive domains are affected in a more obvious manner and non-cognitive disturbances of thought, perception, affect, and behavior put increasing stress on the caregivers. Complete dependence of the patients, who frequently develop neurological disturbances, is typical of the late stage of illness. The life expectancy of patients with a clinical diagnosis of Alzheimer's disease is significantly reduced, but to date there is hope that the period of relative well-being and not of suffering can be prolonged with modern symptomatic treatment interventions.

Diehl J, Monsch AU, Aebi C, Wagenpfeil S, Krapp S, Grimmer T, Seeley W, Förstl H, Kurz A. · Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany. · J Geriatr Psychiatry Neurol. · Pubmed #15681627 No free full text.

Abstract: CERAD-NAB (Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological Assessment Battery) data were compared between 51 patients with frontotemporal dementia, 13 with semantic dementia, and 69 with Alzheimer's disease. There were statistically significant differences between the 3 groups. Compared with patients with Alzheimer's disease, patients with frontotemporal dementia were more impaired on Animal Fluency but not on any other CERAD-NAB subtest. Patients with semantic dementia performed worse in Animal Fluency and Boston Naming Test compared with frontotemporal dementia and Alzheimer's disease. Multiple logistic regression analysis revealed that in the differentiation between frontotemporal dementia and Alzheimer's disease, the combination of Animal Fluency and Boston Naming Test correctly classified 90.5% of patients. In segregating semantic dementia and Alzheimer's disease, the combination of Boston Naming Test and Mini Mental State Examination resulted in a correct classification of 96.3%. These findings demonstrate that the Mini Mental State Examination and the language subtests of the CERAD-NAB are valuable clinical instruments for the differential diagnosis between early frontotemporal dementia, semantic dementia, and Alzheimer's disease.

Diehl J, Mayer T, Kurz A, Förstl H. · Klinik für Psychiatrie und Psychotherapie, Technische Universität München, Möhlstrasse 26, 81675 München. · Nervenarzt. · Pubmed #12966820 No free full text.

Abstract: Eight spouses of patients diagnosed with frontotemporal dementia (FTD) participated in a special support group. Seven weekly sessions of 90-min duration were held. This pilot project provided the opportunity to learn more about FTD and the specific problems and needs of caregivers. Their problems are predominantly due to changes in the patients' personalities and behaviour, not to the cognitive impairment. Furthermore, in contrast to Alzheimer's disease, patients are relatively young, the current state of scientific knowledge about FTD is unsatisfactory, and the disease is almost unknown among physicians. As part of the group activity, caregivers received information on the typical symptoms of FTD. This enhanced their understanding of the alterations in the patients' personalities and behaviour and facilitated acceptance of the disease. During group meetings, participants were encouraged to express their own needs and to deal with painful emotions including aggression, anger, mourning, and guilt. The caregivers felt relieved by sharing their problems with others. They were able to learn from each other and to exchange suggestions and solutions. The group also helped to establish new contacts and friendships. Participants' evaluations of the novel intervention were very positive. We conclude from these initial observations that support groups are needed for caregivers of patients with FTD which are tailored to their specific needs.

Schwalen S, Förstl H. · Klinik und Poliklinik für Psychiatrie & Psychotherapie, TU München. · Neuropsychiatr. · Pubmed #18381055 No free full text.

Abstract: Dementia is a prevalent syndrome in ageing societies and therefore of significant medical and social importance for the general population. We have studied knowledge and attitudes towards Alzheimer's dementia (AD) of 1245 epidemiologically representative individuals between 14 and 99 years. Only 13% mentioned memory disturbances, e.g. forgetfulness, as hallmarks of AD; 54% knew that age was a major risk factor; 47% felt that "brain-jogging" was therapeutically useful. In case of developing AD, more than 70% wished to be informed together with a close relative or friend; 7% felt that nobody else should know about their problem; and many more than 50% expected information on treatment, course, symptoms and causes. These results demonstrate, that there is a remarkable lack of relevant information on AD in the general population, and that most individuals wished to be informed about a potential diagnosis of AD together with their family and friends.

Sorg C, Riedl V, Mühlau M, Calhoun VD, Eichele T, Läer L, Drzezga A, Förstl H, Kurz A, Zimmer C, Wohlschläger AM. · Department of Psychiatry, Klinikum Rechts der Isar, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany. · Proc Natl Acad Sci U S A. · Pubmed #18003904 links to  free full text

Abstract: Alzheimer's disease (AD) is a neurodegenerative disorder that prominently affects cerebral connectivity. Assessing the functional connectivity at rest, recent functional MRI (fMRI) studies reported on the existence of resting-state networks (RSNs). RSNs are characterized by spatially coherent, spontaneous fluctuations in the blood oxygen level-dependent signal and are made up of regional patterns commonly involved in functions such as sensory, attention, or default mode processing. In AD, the default mode network (DMN) is affected by reduced functional connectivity and atrophy. In this work, we analyzed functional and structural MRI data from healthy elderly (n = 16) and patients with amnestic mild cognitive impairment (aMCI) (n = 24), a syndrome of high risk for developing AD. Two questions were addressed: (i) Are any RSNs altered in aMCI? (ii) Do changes in functional connectivity relate to possible structural changes? Independent component analysis of resting-state fMRI data identified eight spatially consistent RSNs. Only selected areas of the DMN and the executive attention network demonstrated reduced network-related activity in the patient group. Voxel-based morphometry revealed atrophy in both medial temporal lobes (MTL) of the patients. The functional connectivity between both hippocampi in the MTLs and the posterior cingulate of the DMN was present in healthy controls but absent in patients. We conclude that in individuals at risk for AD, a specific subset of RSNs is altered, likely representing effects of ongoing early neurodegeneration. We interpret our finding as a proof of principle, demonstrating that functional brain disorders can be characterized by functional-disconnectivity profiles of RSNs.

Egert S, Wagenpfeil S, Förstl H. · Münchner Studienzentrum, Klinikum München rechts der Isar, München, Germany. · Dtsch Med Wochenschr. · Pubmed #17520505 No free full text.

Abstract: BACKGROUND AND OBJECTIVE: The cholinesterase-inhibitors (AChE-I) donepezil, galantamine and rivastigmine are currently used in the symptomatic treatment of patients with Alzheimer's dementia (AD) and the associated cholinergic deficits as well as those with other forms of dementia. Three aspects were analysed: (1) data on their clinical efficacy, (2) differences between North-American and international studies, and (3) potential publication biases. METHODS: Included were data from randomized, placebo-controlled, double-blind parallel group trials on more than 100 patients who had been treated for > or =12 weeks for AD, VaD, dementia with Lewy bodies, dementia with Parkinson's disease or with mild cognitive impairment. RESULTS: These large published trials support the clinical efficacy of AChE-I in patients with mild to moderate AD and other forms of dementia with regard to cognition and global impression. there was a trend towards greater beneficial cognitive effects in North-American studies, but this was non-significant. There was no evidence of a publication bias. CONCLUSIONS: Published data provide evidence for the clinical efficacy of donepezil, galantamine and rivastigmine in patients with mild to moderate AD. There is no indication that these results are critically influenced by the origin or a bias of the publication.

Förstl H. · Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU München, Ismaninger Strasse 22, 81675 Munich, Germany. · Internist (Berl). · Pubmed #17497111 No free full text.

This publication has no abstract.

Bickel H, Mösch E, Förstl H. · Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, Klinikum rechts der Isar, Germany. · Psychiatr Prax. · Pubmed #17443456 No free full text.

Abstract: OBJECTIVE: The suitability of the SIDAM (Structured Interview for the Diagnosis of Dementia) for the detection of pre-clinical stages of dementia. METHODS: Prospective study of a sample of 794 non-demented elderly persons in the age bracket from 65 to 85 who were initially being treated in general hospitals. A cognitive screening with the SIDAM was performed during their stay in the hospital. After discharge the occurrence of dementia was determined in four follow-up studies at one-year intervals. RESULTS: During the follow-up, 100 newly developed cases of dementia were diagnosed. A lower performance in the SIDAM was associated with a significantly higher risk of the development of dementia. In comparison with the upper quartile in total SIDAM score the relative risk of a dementia amounted to 2.6 (1.0-6.8) for the second quartile, 4.5 (1.9-11.0) for the third quartile and 13.3 (5.7-31.1) for the fourth quartile. The highest predictive validity was found for memory performance, in particular for free delayed recall. CONCLUSIONS: Risk groups for dementia can be identified by the use of a brief cognitive screening procedure.

Laws SM, Friedrich P, Diehl-Schmid J, Müller J, Eisele T, Bäuml J, Förstl H, Kurz A, Riemenschneider M. · Neurochemistry and Neurogenetics Laboratory, Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany. · Mol Psychiatry. · Pubmed #17179995 No free full text.

Abstract: In addition to senile plaques, neurofibrillary tangles are characteristic of Alzheimer's disease (AD) pathology, suggesting a clear involvement of the microtubule-associated protein tau (MAPT) in AD. Recent findings, suggesting that the H1c haplotype is associated with increased risk, now also implicate MAPT genetically. In this study, we aim to clarify this association by a fine mapping approach using both a traditional phenotypic association analysis and a quantitative trait (QT) analysis using cerebrospinal fluid (CSF) tau protein levels in the German population. Here, we report that both methodologies identify that the H1c haplotype may play important role in AD (AD risk, P=0.007, uncorrected; CSF tau levels, P=0.027, uncorrected). Further, the use of a sliding window approach in the QT analysis allowed for the narrowing down of the region where a probable causal variant may be located. The data suggest that this may lie at or within close proximity to the rs242557 single nucleotide polymorphism as association with CSF tau levels seems to be primarily driven by rs242557 in a gene dosage-dependent manner (trend model: P=0.002, uncorrected). These findings provide functional evidence to support the genetic association of MAPT with AD.

Riemenschneider M, Konta L, Friedrich P, Schwarz S, Taddei K, Neff F, Padovani A, Kölsch H, Laws SM, Klopp N, Bickeböller H, Wagenpfeil S, Mueller JC, Rosenberger A, Diehl-Schmid J, Archetti S, Lautenschlager N, Borroni B, Müller U, Illig T, Heun R, Egensperger R, Schlegel J, Förstl H, Martins RN, Kurz A. · Neurochemistry and Neurogenetics Laboratory, Department of Psychiatry and Psychotherapy, Technische Universitat München, Ismaningerstrasse 22, 81675 Munich, Germany. · Hum Mol Genet. · Pubmed #16825285 links to  free full text

Abstract: A number of susceptibility loci for Alzheimer's disease (AD) have been identified including a region on Chromosome 10q21-q22. Within this region the plasminogen activator urokinase gene (PLAU) was considered as a reasonable candidate from its functional implication in plasmin generation, a serine protease capable of degrading beta-Amyloid (Abeta) protein. We screened 56 single nucleotide polymorphisms (SNPs) around PLAU using 1751 individuals from four independent case-control samples (Munich, N=679; Bonn N=282; Brescia (Italy) N=219; Perth (Australia) N=557 and one discordant sib-pair sample (Munich N=622). In brain tissue samples of neuropathologically confirmed cases with AD (N=33) we analyzed plaque counts according to the risk allele. We identified that one functional exonic SNP (rs2227564) is associated with development of AD using the four independent case-control samples (Munich, P=0.02; Bonn, P=0.005; Brescia (Italy), P=0.001; Perth (Australia), P=0.03) and the discordant sib-pair sample (P=0.001). In brain tissue, from neuropathologically confirmed cases with AD, we identified significantly higher plaque counts in carriers of the risk allele (N=6; 60.3+/-16.9) compared with non-carriers (N=9; 26.3+/-8.8; P=0.007). This study provides compelling evidence of a genetic and functional involvement of a common PLAU variant into the pathogenesis of AD. Further functional investigations are warranted to elucidate the specific role of PLAU, respectively, PLAU variants in the metabolism of Abeta proteins.

Riemenschneider M, Schoepfer-Wendels A, Friedrich P, Konta L, Laws SM, Mueller JC, Kurz A, Förstl H. · Laboratory of Neurochemistry and Neurogenetics, Department of Psychiatry and Psychotherapy, TU-Munich, 81675 Munich, Germany. <> · Neurobiol Aging. · Pubmed #16784798 No free full text.

Abstract: Using a case-control sample we evaluated a possible involvement of the Vacuolar protein sorting 26 (VPS26) gene in the pathogenesis of AD. VPS26 located at 10q22.1 denotes a retromer subunit functionally involved in the cellular trafficking of Memapsin 2 (BACE). Genotyping of eight single nucleotide polymorphisms covering the complete VPS26 gene and haplotypic analysis revealed no association with AD. Thus, we conclude that VPS26 can be excluded as a major positional and functional candidate gene conferring risk to AD.

Mueller JC, Riemenschneider M, Schoepfer-Wendels A, Gohlke H, Konta L, Friedrich P, Illig T, Laws SM, Förstl H, Kurz A. · Neurochemistry and Neurogenetics Laboratory, Department of Psychiatry and Psychotherapy, Technical University Munich (TUM), Ismaningerstr. 22, 81675 München, Germany. · Neurobiol Aging. · Pubmed #16675064 No free full text.

Abstract: Functional and genetic studies suggest that insulin-degrading enzyme (IDE) may be a strong functional and positional candidate. As there is a lack of consensus in regards to the level and location of IDE association signals we aimed to clarify these discrepancies through genotyping 28 SNPs in a large case-control collective together with quantitative measures of cognitive ability (MMSE). Four SNPs (rs11187007, rs2149632_ide12, rs11187033, rs11187040) were found to be associated with AD (nominal p<0.01). Tests with MMSE scores adjusted for disease duration identified associations, with the most significant result for rs1999763 (nominal p=0.008). Similarly, different reconstructed IDE haplotypes were associated with AD and higher MMSE scores. The association signals are only borderline significant after adjustment for multiple testing, but add further evidence to previous published results on the association between IDE and AD or MMSE. A subgroup analysis indicated more prominent associations with AD in younger, and with MMSE in older patients. There may be two independent effects mediated by IDE variants, risk for AD and modification of disease progression.

Diehl J, Ernst J, Krapp S, Förstl H, Nedopil N, Kurz A. · Psychiatrische Klinik und Poliklinik der TU München, Ismaninger Str. 22, 81675 München. · Fortschr Neurol Psychiatr. · Pubmed #16671160 No free full text.

Abstract: The nature and prevalence of misdemeanor in patients with dementia due to frontotemporal lobar degeneration has been described in a few case reports and in two small U.S. studies. Our clinical impression suggests that antisocial and aggressive behaviour are relatively frequent in this patient population. The objective of the present study was to verify this observation. For this purpose we developed a standardized questionnaire on misdemeanor in Frontotemporal Dementia. Using this instrument caregivers of 30 patients with Frontotemporal Dementia (FTD), 11 patients with Semantic dementia (SD) and 33 patients with Alzheimer-type dementia (AD) were interviewed. The interview included questions about theft, burglary, damaging other peoples' belongings, verbal or physical offence, bodily harm, drug abuse and use of weapons. Questions about the frequency of criminal behaviour, the amount of damages and consequences if applicable completed the questionnaire. Misdemeanor was found in half of the patients with FTD (15 out of 30) and in 7 out of 11 patients with SD, but only in one out of 33 patients with AD. The most frequent type of inappropriate behaviour was theft (13 patients), particularly shoplifting. 8 patients with FTD, 1 patient with SD and 1 patient with AD entered someone else's house without permission. 10 patients with FTD and 3 patients with SD but none of the patients with AD had physically threatened spouses, relatives or strangers. In one case another person was hurt.