Frontal behavioral syndromes in cortical and subcortical dementia

The Frontal Lobe Personality Scale (FLOPS; Grace & Malloy, 1992) was administered to the caregivers of 51 patients with neurodegenerative disease to examine personality and behavioral features associated with prototypical "cortical" dementia (i.e., Dementia of the Alzheimer Type; DAT) and "subcortical" dementia (i.e., Huntington's disease; HD). The FLOPS is a 45-item behavior rating scale designed to identify three frontal syndromes: (a) apathy, (b) disinhibition, and (c) executive dysfunction. Comparing subgroups of HD and DAT that were matched for age and dementia severity (ns = 12), the HD subgroup had higher FLOPS apathy ratings. Using all patients, FLOPS ratings were associated with traditional neuropsychological measures as well as a measure of everyday functioning. Discriminant function analyses, accurately classified over 92% of the DAT patients and nearly 77% of the HD patients, which is consistent with the discriminative utility of other traditional neuropsychological tests. These data suggest that informant-based ratings of so-called "frontal lobe" behaviors may be a useful adjunct to current neuropsychological evaluations in an attempt to characterize personality changes that co-occur with neurodegenerative disease.