Executive Screen : A brief executive battery to differentiate frontotemporal dementia and Alzheimer ’ s

Background and Objective: Executive dysfunctions are a key clinical feature of behavioural-variant frontotemporal dementia (bvFTD). Such deficits are also found in Alzheimer’s disease (AD), making the differentiation between these two diseases difficult at times, particularly in the absence of extensive cognitive assessments. To address this issue, we developed the FRONTIER Executive Screen (FES), which combines three abbreviated measures of verbal fluency, inhibitory control and working memory. Methods: We administered the FES to 28 dementia patients (14 bvFTD, 14 AD) matched for disease severity and 33 ageand education-matched healthy controls. We also administered traditional tests of executive function to establish the concurrent validity of the FES. Results: Both patient groups obtained lower FES scores (total and subscores) compared to controls. Correct classification into patient or control groups was reached in over 90% of study participants based on the FES total score. Only two bvFTD patients obtained FES scores within 2 standard deviations of the control group. ROC analyses on the patient groups showed that a cut-off FES total score of 7/15 achieved 71% sensitivity and 73% specificity for a diagnosis of bvFTD. In addition, the FES showed high correlations with traditional measures of executive function. Conclusions: The FES is a brief (5-10 min) bedside screening measure which is simple to administer and score, and demonstrates good discriminative validity to differentiate bvFTD from AD. It is a useful addendum to general cognitive screening measures and can help with the differential diagnosis of dementia.