Few studies to date have specifically examined gender differences in patients with frontotemporal dementia (FTD). A new study has investigated this issue in 26 patients with behavioural-variant FTD (Koros et al. EAN 2015; abstract F2014). Cognitive and behavioural symptoms in 26 males and females were compared based on neuropsychological and behavioural testing and patient history. The scales used were the Neuropsychiatric Inventory (NPI) and the Frontal Behavioral Inventory (FBI). 

There were no gender differences with respect to the prevalence of cognitive symptoms or on neuropsychological scores for episodic memory, executive function or speech. However, there were significant differences in behavioural symptoms: overall NPI and FBI scores were higher in males. Men were more significantly more likely to exhibit disinhibition, aggressiveness, and dietary change (e.g. overeating, sweet craving). Women were more likely to demonstrate neglect in personal care. There was no difference between the groups in the frequency of apathy, social withdrawal, or psychiatric symptoms (depression, obsessive-compulsive symptoms).

Prior studies have indicated greater cerebral hypometabolism and a higher frequency of non-cognitive behavioural symptoms (e.g. loss of insight, abnormal speech, apathy) in males with FTP (Perneczky et al. Int J Geriatr Psychiatry 2007;22:1135-1140; Diehl & Kurz. Int J Geriatr Psychiatry 2002;17:914-918).

Comment:
Dr. Catherine Brodeur:  Although we already knew that there is a gender difference in the epidemiology of FTD – men being much more commonly affected than women – little is known about gender difference in the clinical presentation of FTD. This study is interesting, but one caveat is that it has been done with a very small number of patients.