RESEARCH LETTER When behavioral assessment detects frontotemporal dementia and cognitive testing does not: data from the Frontal Behavioral Inventory Graziella Milan 1,2 , Alessandro Iavarone 3 , Elisa Lore ` 2 , Sara Vitaliano 3 , Francesco Lamenza 4 , Paolo Sorrentino 1 and Alfredo Postiglione 2 * 1 Centro Geriatrico Sovradistrettuale ‘Frullone’, ASL Napoli 1, Naples, Italy 2 Department of Clinical and Experimental Medicine, University of Naples ‘Federico II’, and AOUP ‘Federico II’, Naples, Italy 3 Neurological and Stroke Unit, CTO Hospital, Naples, Italy 4 UC Geriatria per Acuti, Rossano Hospital, Cosenza, ASL Cosenza 3, Italy Diagnostic criteria of frontotemporal dementia (FTD) include the presence of both cognitive impairment and behavioral changes (Neary et al., 1998). The cognitive profile of FTD patients, especially those presenting with the clinical picture of the frontal variant FTD (fv-FTD), is characterized by predominant executive impairment with relative sparing in instrumental abilities. Furthermore, fv-FTD patients often show important behavioral disorders that may precede the appearance of overt cognitive impairment (Binetti et al., 2000). On the other hand, patients suffering from Alzheimers’s disease (AD) or vascular dementia (VaD) may show significant executive impairment even in the early stages of the disease. Furthermore, behavioral and psychological symptoms are widely represented across the main forms of dementia. These findings may account for the partial overlapping in the presentation of the different types of dementia and for the difficulties in performing a precise differential diagnosis on clinical grounds. The Frontal Behavioral Inventory (FBI) is a 24-item caregiver-based behavioral questionnaire designed for the diagnosis and quantitation of symptoms of fv-FTD (Kertesz et al., 1997; 2000). The aim of this study was to evaluate discriminating properties of the FBI in patients suffering from different forms of dementia. In order to better define the specific characteristic of the FBI, patients with fv-FTD were matched with subjects with AD and VaD according to comparable degrees of both dementia severity and executive impairment. Thirty-five patients with fv-FTD, 22 affected by AD and 15 by VaD were studied. All patients received the Mini Mental State Examination (MMSE). The subjects from the three groups were selected among those treated in our Memory Clinics by showing comparable grading of dementia, as assessed by the Clinical Dementia Rating (CDR), and comparable executive functioning, evaluated by the Frontal Assessment Battery (FAB). The caregivers of all patients completed: (1) the FBI; (2) the Neuropsy- chiatric inventory to assess psychopathology (NPI-P). Table 1 shows mean, standard deviations and score range of the FBI in the three groups of patients. Scores of FBI were significantly correlated with scores of FAB (r ¼0.308; p < 0.01) (negative) and with the ‘frontal’ items of the NPI-P (r ¼ 0.447; p < 0.0001) INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2007; 22: 266–267. Published online 12 January 2007 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/gps.1697 *Correspondence to: Dr A. Postiglione, Department of Clinical and Experimental Medicine, University of Naples ‘Federico II’, & AOUP ‘Federico II’, via S. Pansini 5, 80133 Napoli, Italy. E-mail: alfposti@unina.it Copyright # 2007 John Wiley & Sons, Ltd. Received 20 March 2006 Accepted 11 September 2006