Frontotemporale lobäre degenerationen: Analyse medizinischer risikofaktoren

Frontotemporal lobar degenerations (FTLD) are the cause of 30 to 50% of presenile dementias. A positive family history of dementia is present in approximately 40% of FTLD patients. Evidence of autosomal dominant transmission, however, is only found in less than 10% of cases. This suggests that non-genetic factors have a role in the aetiology of these neurodegenerative disorders. In the present case-control study we assessed the personal history of 82 German patients with FTLD (frontotemporal dementia - FTD, semantic dementia - SD, and primary progressive aphasia - PPA) and compared it with data of 82 cognitively healthy individuals matched for age and sex. The case-control study focused on diseases for which a possible association with cognitive impairment has been demonstrated: hypertension, hypercholesterolaemia, myocardial infarction, stroke, diabetes, thyroid disorders, head trauma with loss of consciousness, and depression. We included information on nicotine and alcohol use as well as on alcohol dependence. None of the somatic conditions investigated was significantly more frequent in patients with FTD than in age-matched cognitively healthy individuals. The number of smokers was almost identical in both groups. Regular intake of alcohol was less common among FTLD patients than among healthy subjects. Due to the relatively low prevalence of FTLD the search for risk factors is difficult. However, research in this area must be pushed ahead since the identification of risk factors can reveal new insights into pathophysiological mechanisms and may ultimately pave the way for therapeutic and preventive strategies.