A 4-year follow-up of very old patients presenting with frontal-subcortical dysfunction compared with Alzheimer's disease patients.

BACKGROUND Frontal-subcortical clinical syndrome (FSCS) is frequently described in elderly patients and consists of specific alterations in cognition and motor functions. This clinical picture may be associated with a high level of dependence and a high mortality risk. OBJECTIVE We report the risks of institutionalization and death during a follow-up of 4 years in patients showing FSCS. METHODS The study was initiated in 1998 to compare FSCS patients showing postural and gait abnormalities with Alzheimer's disease (AD) patients. Follow-up was conducted by means of telephone interviews with the patient's general practitioner over a 4-year period (1998-2002). RESULTS Both institutionalization and mortality rates were significantly higher (p < 0.05) in the FSCS group compared to the AD group. CONCLUSIONS The high risk of disability and death in FSCS patients suggests that they might require specific care programs that include stimulation in daily living activities in order to reduce the risk of institutionalization and to improve quality of life.