26 Thus, presence and severity of symptoms largely depend on the stage at which the patient has been observed. Second, Epigenetic inhibitor research buy methodological reasons may also contribute to heterogeneity. Only in the last decade have symptom detection and quantification been evaluated by means of structured or semistructured scales, validated in large groups of patients. This has allowed for more
objective descriptions of symptoms, as well as attempts to compare different reports. Nevertheless, the prevalence rate seems to be still largely influenced by the clinical Inhibitors,research,lifescience,medical diagnostic criteria used for evaluation.27 Finally, since a few reports are corroborated by postmortem pathological confirmation, misdiagnoses should be considered as a potential cause of heterogeneity. For example, if the temporal variant of FTD is erroneously included in AD dementia groups (differential diagnosis may not be easy at earlier stages) manifestations of this type of dementia might, indeed, be considered proper Inhibitors,research,lifescience,medical to AD. There is some agreement in Inhibitors,research,lifescience,medical considering major depression and, in general, the affective disorders, as common symptoms either at the onset28 and throughout the entire clinical course of AD.29-34 Pathological anxiety is also reported.35 The average frequency of depression
is approximately 40% (see ref 36 for a review) even if its prevalence seems to decrease over time.37 Apathetic behavior, which is significantly correlated with but distinct from depression,38,39 also seems to be widely represented in AD40 and is considered as a factor predicting more aggressive dementia.41 Psychotic symptoms, and specifically
delusions and hallucinations, are also described as frequent manifestations in the clinical course of AD,42-45 Inhibitors,research,lifescience,medical mostly in later stages.46 Paranoid misidentifications, such as in Capgras’ syndrome, have also been occasionally reported.47 The emergence of psychotic symptoms is currently considered to predict Inhibitors,research,lifescience,medical faster cognitive and functional decline48-53 as well as increased risk of mortality,54 even if some studies lead to different conclusions.55 A relationship between psychotic symptoms, age at onset, and disease duration has also been pointed out by some authors (see ref 56 for a review). Currently, Terminal deoxynucleotidyl transferase there are descriptions of other noncognitive symptoms, primarily pathological conduct, which merge into a large variety of syndromes.57 Agitation, aggression,58-60 aberrant motor behavior and wandering,57 sleep and eating disorders,61,62 and impaired insight63 are frequently described in association with depression or psychoses. FTD As previously mentioned, most research on noncognitive disorders in FTD consists of comparative studies between the two most frequent forms of dementia, AD and FTD. Only in more recent years have comparisons been made with vascular dementia,64,65 DLB, or Parkinson’s disease.