Predictors of Neurodegenerative Disorders Identified
Social inappropriateness and other behavioral manifestations in middle-aged patients may predict neurodegenerative disorders years before patients demonstrate any noticeable cognitive impairment, according to a recent literature review.
New onset of mood and behavioral changes in middle-aged patients are often the first signs of an unrecognized neurocognitive disorder, particularly in individuals developing prodromal stages of behavioral-variant frontotemporal dementia (bvFTD), Alzheimer's disease (AD), idiopathic Parkinson's disease (IPD), and Lewy body dementia (LBD).
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According to the researchers, behavioral changes characteristic of new-onset neurodegenerative disorders include impaired social cognition, such as gradual loss of ability to process the emotions of others, to attribute mental states to others, and to respond appropriately to them.
Other manifestations that often precede neurodegenerative disorders include lack of self-control, reduced perception of social cues like facial emotions and sarcasm, and impaired Theory of Mind. Loss of empathy, inappropriateness of affect, and disinhibition are specifically associated with prodromal bvFTD and prodromal AD.
However, not all neurodegenerative disorders are preceded by social cognitive impairment. Unlike bvFTD and AD, social impairment in IPD occurs later as the disease progresses.
“Through various manifestations, social inappropriateness is frequently the first clinical sign of a neurodegenerative process, especially in AD and bvFTD, years before noticeable impairment on classical neuropsychological assessment and brain atrophy on imaging,” the researchers concluded.
—Christina Vogt
Reference:
Desmarais P, Lanctôt KL, Masellis M, Black SE, Herrmann N. Social inappropriateness in neurodegenerative disorders [Published online July 10, 2017]. Int Psychogeriatr. doi:10.1017/S1041610217001260.