Alzheimer Disease vs Frontotemporal Dementia
Alzheimer Disease and Frontotemporal Dementia are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Alzheimer Disease vs Frontotemporal Dementia at a glance
- Alzheimer Disease: Most common neurodegenerative dementia; insidious memory loss with cortical amyloid and tau pathology.
- Frontotemporal Dementia: Early-onset dementia syndromes characterized by frontal-temporal degeneration; presents as behavioral change or progressive aphasia.
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Side-by-side comparison
| Feature | Alzheimer Disease | Frontotemporal Dementia |
|---|---|---|
| At a glance | Most common neurodegenerative dementia; insidious memory loss with cortical amyloid and tau pathology. | Early-onset dementia syndromes characterized by frontal-temporal degeneration; presents as behavioral change or progressive aphasia. |
| Classic presentation | Profound short-term memory loss with relatively preserved older memories and intact remote procedural memory; hippocampal/medial temporal atrophy on MRI.;… | Mid-50s patient with new socially inappropriate behavior, apathy, or progressive nonfluent speech, with disproportionate frontal/temporal atrophy on MRI.;… |
| Workup / key labs | NIA-AA: probable AD dementia = insidious onset, progressive cognitive decline, predominant memory or non-amnestic syndrome, exclusion of other causes.… | Rascovsky 2011 (bvFTD): ≥3 of 6 behavioral features (disinhibition, apathy, loss of sympathy/empathy, perseverative/compulsive behavior, hyperorality,… |
| Imaging | MRI brain (or CT if MRI contraindicated): generalized and disproportionate medial temporal/hippocampal atrophy; excludes vascular disease, NPH, masses,… | MRI brain — frontal and/or anterior temporal atrophy (often asymmetric; left perisylvian in nfvPPA, anterior temporal in svPPA); FDG-PET — frontal and… |
| First-line treatment | Cholinesterase inhibitor (AChE inhibitor) — donepezil, rivastigmine (oral or transdermal patch), galantamine; modest symptomatic benefit for mild-to-moderate… | No disease-modifying therapy approved; SSRIs (sertraline, citalopram, escitalopram, trazodone) — first-line for disinhibition, compulsive behaviors,… |
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