Predictors of functional decline among patients with frontotemporal disorders
by diagnosis 
   Lead Investigator:    Kristin Sweeney
   Institution      :    Massachusetts General Hospital
   E-Mail           :    kristin.sweeney@mgh.harvard.edu
   Proposal ID      :    967



   Proposal Description:
   Goal: To better understand the rate of functional decline among patients diagnosed with PPA-S, PPA-G, bv-FTD, PSP, AD, and CBD.                            Hypotheses:   1) Patients with FTD have significantly different rates of functional decline such that patients diagnosed with PPA-G, PSP, CBD have significantly higher rates of mean functional decline than do patients diagnosed with bv-FTD and PPA-S.   2) Most FTD subgroups have faster average rates of decline than patients diagnosed with Alzheimer?s disease, with the exception of patients with PPA-S.                                                 Analysis: A multiple regression statistical analysis will be conducted. The outcome, functional decline, will be measured by comparing change in scores on the Functional Activities Questionnaire (FAQ) over two or more time points. The predictor of interest is the diagnosis at baseline.  Control variables may      include age, years of education, CDR sum of boxes at baseline, years since symptom onset, and family history and genetic status.   Impact on field: In clinical settings, patients and families affected by FTD often wonder and ask clinicians about their expected rate of progression, ?What will I be like next year?? Although previous research has shown that patients with FTD have a faster functional decline than do patients with FTD, there is a dearth of research exploring differences in mean rate of functional decline between specific FTD diagnosis.  More information about functional decline can help families plan for the future and make decisions about when to retire, when to enter assisted living and skilled nursing care, when to initiate conversations with the patient about advanced directives, etc. From a research perspective, more information about mean rate of functional decline may also assist in designing future drug trials and tailoring length of drug trials to the differential time courses of specific subtypes of FTD.