Researchers from the University of Queensland discovered that almost 70 percent of the suspected prontotemporal dementia patients did not ultimately have the disease, a study aimed at identifying factors that contribute to a wrong diagnosis of this notoriously difficult to diagnose disorder.
Psychiatrist Dr. Joshua Flavell“ Working with cognitive neurologist Professor Peter Nestor At the Mater Hospital Memory and Cognitive Disorders Clinic and UQs Queensland Brain Institute, analyzed data from 100 patients suspected of frontotemporal dementia that had been referred by specialized doctors such as neurologists, psychiatrists or geriatricians.
Of the 100 patients, 34 were true-positive and 66 were false positive for frontotemporal dementia.
We found that the wrong interpretation of brain scans, in particular nuclear imaging, led 32 patients to be diagnosed incorrectly.
Similarly, cognitive tests such as tests of the executive function have also contributed to wrong diagnoses in 20 patients. “
Dr. Joshua Flavell, psychiatrist
The study compared the initial referral information with the final clinical diagnoses to determine patterns in diagnostic accuracy.
Frontotemporal dementia is one of the most common forms of dementia in people under the age of 65.
In contrast to Alzheimer’s that is characterized by memory problems, Frontotemporal dementia includes degeneration of the frontal and temporary lobes of the brain, which influences personality and behavior.
Dr. Flavell said that the study emphasized the need for careful interpretation of diagnostic tests in patients suspected of having the disease.
“We found that patients with previous psychiatric histories often had the wrong diagnosis,” he said.
“Misinterpretation of brain scans and cognitive tests, in particular formal neuropsychological tests, has contributed considerably to inaccurate diagnoses.”
Professor Nestor said that doctors should be careful not to interpret the results of neuroimaging and neuropsychology and to be hesitant to label behavioral change as frontotemporal dementia in patients with previous psychiatric histories.
“More emphasis must be placed on direct observation of behaviors associated with frontotemporal dementia and physical neurological signs in the clinic, rather than just trusting second -hand reports of symptoms,” he said.
“The team compared the initial referral diagnosis of suspected frontotemporal dementia with the outcome in the long term, following people who have been confident for five years in the diagnosis.
“By increasing the awareness of these pitfalls in the diagnostic process, we believe that diagnostic accuracy for frontotemporal dementia can be improved.”
The research was published in the European Journal of Neurology.
Source:
Journal Reference:
Flavell, J., et Alt Alto. (2025). Factors associated with true -positive and false positive diagnoses of behavioral variant frontotemporal dementia in 100 consecutive references from specialized doctors. European Journal of Neurology. doi.org/10.1111/ene.70036.