Researchers Study Eating Abnormalities in Frontotemporal Dementia Subtypes

A team of researchers from Australia aimed to determine the occurrence of eating abnormalities in subtypes of frontotemporal dementia (FTD) besides the well established behavioral variant of frontotemporal dementia (bvFTD). The study entitled “Quantifying the Eating Abnormalities in Frontotemporal Dementia”, was recently published in JAMA Neurology.

Evidence shows that abnormal eating behaviors are present in up to 60% of patients with frontotemporal dementia (FTD). Eating abnormalities are one of the main criteria to diagnose behavioural variant FTD (bvFTD). These abnormal eating behaviours include appetite changes, increased carbohydrate intake, changes in food preference, including increased sweets intake. These eating alterations have been also observed in patients with semantic dementia (SD).

There is a lack of evidence of systematic comparisons of eating changes in patients with bvFTD and SD. In this regard, Olivier Piguet and colleagues compared patients with bvFTD (N=21) and semantic dementia (SD) (N=26) with patients with Alzheimer disease (AD) (N=28) and healthy control participants (N=18). Eating behavior included energy, sugar, carbohydrate, protein, and fat intake, as well as indices of metabolic health.

Participants were recruited from FRONTIER, the FTD clinic at Neuroscience Research Australia in Sydney. All the 73 participants were assessed with clinical interview, neurologic examination, cognitive assessment, and structural brain magnetic resonance imaging. Results revealed that the bvFTD group had higher abnormalities in appetite, eating habits, food preferences and swallowing, when compared with the AD group. The bvFTD and SD groups revealed increased energy consumption. The bvFTD also had higher levels of carbohydrate intake compared to controls, and the SD group had significantly increased sugar intake. The SD group was found to have lower hunger and satiety scores compared with the bvFTD group. Moreover, eating abnormalities was found in the 2 groups (bvFTD and SD) with the highest body mass index and waist circumference.

Based on these results, Olivier Piguet and colleagues indicate that abnormal eating behaviors are more obvious in patients with bvFTD and those with SD. However, eating abnormalities are not limited to increased appetite, but also involve higher intake of sugar and carbohydrates. This study revealed the higher levels of sugar and carbohydrate consumption found in patients with FTD subtypes and those with higher body mass index and waist circumference only increased hunger or lower satiety. The researchers suggest that future studies should include actinography to understand caloric intake vs expenditure.