According to a new study published in the JAMA Neurology journal, people with frontotemporal dementia (FTD) from different ethnic backgrounds exhibit varying symptoms. These findings underline the risk of misdiagnosis for people from certain ethnic backgrounds, and the need for efforts to promote equitable access to an accurate, timely diagnosis for all. FTD, like Alzheimer’s disease, is a progressive, neurodegenerative disease that affects the way people think, function and behave. Caused by damage to brain cells in the frontal and temporal lobes, FTD causes particular symptoms such as loss of empathy and foresight, and issues with speaking or moving. Most people are diagnosed with FTD earlier in life (in their 50’s and 60’s), usually based on a clinical evaluation by doctors. However diagnosis of FTD is challenging, as people are often younger and symptoms can overlap with neuropsychiatric disorders.
The goal of the new study, led by Lauren Massimo at the University of Pennsylvania, was to examine differences in clinical disease severity, function, and neuropsychiatric symptoms and at initial presentation comparing people with caucasian, asian or african-american backgrounds, with a diagnosis of FTD. To do this, they used National Alzheimer’s Coordinating Center (NACC) data to determine whether clinical disease severity and neuropsychiatric symptoms differ between ethnic groups. In their study, the researchers observed that african-american individuals had a greater frequency of delusions, agitation, and depression compared to caucasian individuals. Individuals with an asian background had a greater frequency of apathy, night-time disturbances, and appetite/eating changes compared to caucasian individuals.
The study also found that african-american people with FTD had higher levels of clinical disease severity and functional impairment at initial visit compared to other ethnic groups, even though they did not differ in symptom duration. These preliminary findings suggest that there are differences in neuropsychiatric symptoms and the extent of functional impairment between different ethnic groups. Considering the diagnosis of FTD is based on clinical symptoms, the existence of these ethnic disparities is concerning as certain patients with FTD may be at particular risk for misdiagnosis if their symptom profile does not fit within the current clinical criteria. Further research on facilitators and barriers to FTD diagnosis for different ethnic groups is required, to help researchers develop more effective strategies for engaging currently underrepresented individuals. Read the article:
https://jamanetwork.com/journals/jamaneurology/fullarticle/2809452
