Education plays a different role in Frontotemporal Dementia and Alzheimer’s disease Barbara Borroni * , Antonella Alberici, Chiara Agosti, Enrico Premi and Alessandro Padovani Department of Neurology, University of Brescia, Italy SUMMARY Background The role of modifiable and non-modifiable variables in Frontotemporal Dementia (FTD) as compared to Alzheimer’s dDisease (AD) and to Progressive Supranuclear Palsy (PSP) or Corticobasal Degeneration Syndrome (CBDS) has not been extensively evaluated. In particular, low education levels have been reported to be a risk factor for AD, but their contribution in FTD is yet not known. Objective To investigate the role of education, other modifiable and non-modifiable factors in FTD as compared to AD, PSP and CBDS patients. Methods One hundred and seventeen FTD patients, 400 AD, 55 PSP, and 55 CBDS entered the study. Demographic and clinical characteristics were carefully recorded. Age, gender, family history for dementia and Apolipoprotein E (APOE) genotype were considered as non-modifiable factors; education and comorbidities were included as modifiable variables. Regression analyses were applied in order to identify differences among groups. Results FTD differed from AD patients in terms of younger age, positive family history and gender status. In regard to APOE genotype, no differences between FTD and AD were found, but FTD showed higher prevalence of epsilon 4 allele compared to both CBDS and PSP patients ( p < 0.05). When modifiable factors were considered, FTD were higher educated than AD patients ( p < 0.001). Regression analysis identified younger age, positive family history, and education levels as independently associated variables to FTD diagnosis compared to AD (F ¼ 21.27, R 2 ¼ 24.1, p ¼ 0.036). Conclusion Our results highlight that the contribution of education and non-modifiable factors is likely different in FTD and AD. Further work is needed to completely establish the role of this modifiable variable as a potential area of intervention for dementias. Copyright # 2008 John Wiley & Sons, Ltd. key words — Frontotemporal Dementia; Alzheimer’s disease; education; Apolipoprotein E INTRODUCTION Frontotemporal Dementia (FTD) is one of the most common forms of dementia after Alzheimer’s disease (AD) (McKhann et al., 2001). At the disease onset, the main clinical features are variably represented by social misconduct and behavioral disturbances, impairment in language and executive functions, and motor deficits, described as atypical extrapyr- amidal syndromes or motor neuron disease (Hodges et al., 2004; Rosen et al., 2005). The disease rapidly progresses to global dementia. At present, a wide spectrum of heterogeneous clinical and anatomical conditions are referred under the term FTD, and therefore the concept of Pick’s Complex was adopted (Kertesz et al., 2003). The sharing of a common genetic and pathological overlap with Progressive Supranuclear Palsy (PSP) and Corticobasal Degener- ation Syndrome (CBDS) promoted the inclusion of these movement disorders belonging to the same label of FTD (Kertesz et al., 2005). Although FTD is a sporadic disease, a high proportion of patients have an important autosomal dominant familial trait of inheritance (Chow et al., 1999), and MAPT tau and Progranulin genes seem to have the major role (Spillantini and Goedert, 2000; Baker et al., 2006; Cruts et al., 2006). However, after INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2008; 23: 796–800. Published online 3 January 2008 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/gps.1974 *Correspondence to: B. Borroni, Department of Neurology, Pza Spedali Civili, 1, 25100 Brescia, Italy. E-mail: bborroni@inwind.it Copyright # 2008 John Wiley & Sons, Ltd. Received 19 May 2007 Accepted 12 November 2007