Clinical Observations in Geriatrics
Published: 2016-03-15

Depression or prodromal fronto-temporal dementia?

School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan, Italy
School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan, Italy
Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences & Community Health, University of Milan, Italy
Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences & Community Health, University of Milan, Italy
Fronto-temporal dementia Depression Elderly

Abstract

Introduction. Frontotemporal dementia (FTD) is a rare neurodegenerative disease, occasionally late onset,
whose prevalence is underestimated especially in the geriatric population. The initial symptoms can be confused
with some psychiatric disorders, such as depression, so the differential diagnosis may require careful
investigations. Here we report the case of a 75 years old patient presenting with severe anxiety symptoms,
initial social withdrawal and mild cognitive impairment.
Materials and methods. Longitudinal observational clinical study of 3 years. The patient underwent three
successive cognitive assessments that included the Mini Mental State Examination (MMSE) and a battery of
neuropsychological tests, imaging studies of the brain with a computer tomography (CT), magnetic resonance
imaging (MRI) and positron emission tomography (PET) and genetic analysis of a few possible mutations involved
in FTD (C9ORF72, progranulin).
Results. The results after the first visit showed a picture of non amnesic single cognitive domain (dysexecutive)
Mild Cognitive Impairment (MCI) associated with anxious-depressive symptomatology. The initial neuroimaging
demonstrated fronto-temporal cortical atrophy with mild enlargement of the frontal horns of the lateral
ventricles, and moderate glucose hypometabolism of bilateral prefrontal cortex. Genetic tests were instead
negative. These data were suggestive of a diagnosis of prodromal FTD. However, in the three years follow-up,
following a treatment with paroxetine the patient completely resolved her depressive symptoms, and in parallel
she did not worsen her cognitive status nor developed behavioural disorders. Therefore we concluded for a
depressive disorder and we diminished our suspects for a prodromal dementia.

Affiliations

S. Damanti

School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan, Italy

F.Y. Romano

School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan, Italy

C. Abbate

Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

G.L. Schinco

Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

P.D. Rossi

Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

D. Mari

Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences & Community Health, University of Milan, Italy

M. Marcucci

Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences & Community Health, University of Milan, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2016

How to Cite

[1]
Damanti, S., Romano, F., Abbate, C., Schinco, G., Rossi, P., Mari, D. and Marcucci, M. 2016. Depression or prodromal fronto-temporal dementia?. JOURNAL OF GERONTOLOGY AND GERIATRICS. 64, 1 (Mar. 2016), 25-30.
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