Overlap between frontotemporal dementia and Alzheimer’s disease: case report

The frontal variant of Alzheimer’s disease (fv-AD) has been described in patients with prominent behavioral or executive dysfunctions. Subsequently, the spectrum of frontal variant Alzheimer’s disease has been enlarged to comprise patients with early personality and behavioral changes including disinhibition, apathy or compulsiveness. We describe the case of a patient with a history of memory loss and behavioral changes. The neuropsychological profile overlapped with the presence of behavioral disorders such as marked apathy, disinhibition, hostile behavior, agitation, irritability and hyperorality. The results of the neuropsychological examination leaned towards a diagnosis of frontotemporal circuit functional impairment, however, the 18-FDG PET study demonstrated a moderate-to-severe impairment in the bilateral parietal regions. On the basis of the neuropsychological profile and 18-FDG PET imaging, a diagnosis of a probable fv-AD was made, the patient started oral rivastigmine 3 mg/daily and subsequent assessments showed only modest worsening in the cognitive profile and a moderate improvement in behavioral symptoms.