Incidence of frontotemporal lobar degeneration in Italy

Objective The goal of the present work, based on a collaborative research registry in Italy (the Salento-Brescia Registry), was to assess the incidence of frontotemporal lobar degeneration (FTLD) and to define the frequencies of different FTLD phenotypes in the general population. Methods The study was conducted from January 1, 2017, to December 31, 2017, in 2 Italian provinces: Lecce (in Puglia) in the south (area 2,799.07 km2, inhabitants 802,082) and Brescia (in Lombardy) in the north (area 4,785.62 km2, inhabitants 1,262,678). During the study period, all new cases of FTLD (incident FTLD) were counted, and all patients' records were reviewed. The incidence was standardized to the Italian general population in 2017. Results In the 2 provinces, 63 patients with FTLD were diagnosed. The incidence rate for FTLD was 3.05 (95% confidence interval [CI] 2.34–3.90) per 100,000 person-years (py), while the age-sex standardized incidence rate was 3.09 (95% CI 2.95–3.23) per 100,000 py. In the Italian population, the lifetime risk was 1:400. There was a progressive increase in FTLD incidence across age groups, reaching its peak in the 75- to 79-year-old group, with an incidence rate of 15.97 (95% CI 8.94–26.33) per 100,000 py. The behavioral variant of frontotemporal dementia was the most common phenotype (37%). No difference in crude incidence rate between the 2 provinces was observed. Conclusion FTLD is a more common form of dementia than previously recognized, with a risk spanning in a wide age range and with maximum incidence in the mid-70s. Improved knowledge of FTLD epidemiology will help to provide appropriate public health service policies.

[1]  E. Beghi,et al.  Referral bias in ALS epidemiological studies , 2018, PloS one.

[2]  A. Singleton,et al.  Clinical and genetic analyses of familial and sporadic frontotemporal dementia patients in Southern Italy , 2017, Alzheimer's & Dementia.

[3]  C. Brayne,et al.  Benefits, pitfalls, and future design of population-based registers in neurodegenerative disease , 2017, Neurology.

[4]  W. Rocca,et al.  Time Trends in the Incidence of Parkinson Disease. , 2016, JAMA neurology.

[5]  J. Rowe,et al.  Prevalence, characteristics, and survival of frontotemporal lobar degeneration syndromes , 2016, Neurology.

[6]  S. Mead,et al.  Review: An update on clinical, genetic and pathological aspects of frontotemporal lobar degenerations , 2015, Neuropathology and applied neurobiology.

[7]  Stefano Cappa,et al.  Early stage of behavioral variant frontotemporal dementia: clinical and neuroimaging correlates , 2015, Neurobiology of Aging.

[8]  B. Borroni,et al.  Phenotypic Heterogeneity of Monogenic Frontotemporal Dementia , 2015, Front. Aging Neurosci..

[9]  V. Feigin,et al.  Development of the standards of reporting of neurological disorders (STROND) checklist: a guideline for the reporting of incidence and prevalence studies in neuroepidemiology , 2015, European Journal of Epidemiology.

[10]  Hannah A. Pliner,et al.  Searching for Grendel: origin and global spread of the C9ORF72 repeat expansion , 2014, Acta Neuropathologica.

[11]  R. Laforce Behavioral and language variants of frontotemporal dementia: A review of key symptoms , 2013, Clinical Neurology and Neurosurgery.

[12]  J. Trojanowski,et al.  Contribution of cerebrovascular disease in autopsy confirmed neurodegenerative disease cases in the National Alzheimer's Coordinating Centre. , 2013, Brain : a journal of neurology.

[13]  John-Paul Taylor,et al.  Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review , 2013, Aging Clinical and Experimental Research.

[14]  J. Diehl-Schmid,et al.  The epidemiology of frontotemporal dementia , 2013, International review of psychiatry.

[15]  Mark Hallett,et al.  Criteria for the diagnosis of corticobasal degeneration , 2013, Neurology.

[16]  A. Chiò,et al.  ALS clinical trials , 2011, Neurology.

[17]  O. Zanetti,et al.  Prevalence and Demographic Features of Early-Onset Neurodegenerative Dementia in Brescia County, Italy , 2011, Alzheimer disease and associated disorders.

[18]  Nick C Fox,et al.  Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. , 2011, Brain : a journal of neurology.

[19]  D. Knopman,et al.  Estimating the Number of Persons with Frontotemporal Lobar Degeneration in the US Population , 2011, Journal of Molecular Neuroscience.

[20]  B. Miller,et al.  Classification of primary progressive aphasia and its variants , 2011, Neurology.

[21]  J. Garre-Olmo,et al.  Incidence and subtypes of early-onset dementia in a geographically defined general population , 2010, Neurology.

[22]  E. Beghi,et al.  Incidence of amyotrophic lateral sclerosis in Europe , 2009, Journal of Neurology, Neurosurgery & Psychiatry.

[23]  M. Hernán,et al.  Incidence and lifetime risk of motor neuron disease in the United Kingdom: a population‐based study , 2009, European journal of neurology.

[24]  J R Hodges,et al.  Incidence of early-onset dementias in Cambridgeshire, United Kingdom , 2008, Neurology.

[25]  E. Beghi,et al.  Descriptive epidemiology of amyotrophic lateral sclerosis: new evidence and unsolved issues , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[26]  S. Pocock,et al.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies , 2007, The Lancet.

[27]  Matthias Egger,et al.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies , 2007, PLoS medicine.

[28]  R. Petersen,et al.  The incidence of frontotemporal lobar degeneration in Rochester, Minnesota, 1990 through 1994 , 2004, Neurology.

[29]  M N Rossor,et al.  The prevalence and causes of dementia in people under the age of 65 years , 2003, Journal of neurology, neurosurgery, and psychiatry.

[30]  M. Sjögren,et al.  The prevalence of frontal variant frontotemporal dementia and the frontal lobe syndrome in a population based sample of 85 year olds , 2003, Journal of neurology, neurosurgery, and psychiatry.

[31]  Y Ben-Shlomo,et al.  How valid is the clinical diagnosis of Parkinson's disease in the community? , 2002, Journal of neurology, neurosurgery, and psychiatry.

[32]  J R Hodges,et al.  The prevalence of frontotemporal dementia , 2002, Neurology.

[33]  Domenico Inzitari,et al.  Incidence of Dementia, Alzheimer's Disease, and Vascular Dementia in Italy. The ILSA Study , 2002, Journal of the American Geriatrics Society.

[34]  M. Hallett,et al.  Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) , 1996, Neurology.

[35]  E. Kokmen,et al.  Impact of referral bias on clinical and epidemiological studies of Alzheimer's disease. , 1996, Journal of clinical epidemiology.

[36]  J. Estève,et al.  Statistical methods in cancer research. Volume IV. Descriptive epidemiology. , 1998, IARC scientific publications.