Clinical and structural correlates of nutritional impairment in behavioral variant frontotemporal dementia

OBJECTIVES: Frontotemporal dementia (FTD) is characterized by prominent behavioral disturbances and alterations in eating behavior, which may result in distinct nutritional profiles. This study aimed to evaluate nutritional status in patients with behavioral variant FTD (bvFTD) and to examine its associations with clinical parameters and structural brain changes. METHODS: In this retrospective cross-sectional study, 94 patients with bvFTD were included. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Of these, 68 patients with available MNA-SF data were included in the final analyses. Patients were classified into normal and impaired nutritional status groups. Clinical variables, including body mass index (BMI), cognitive performance, depression, anxiety, and fall risk, were analyzed. Brain regions associated with eating behavior were evaluated using visual rating scales, and composite measures. RESULTS: Nutritional impairment was identified in 61.8% of patients. The impaired group had significantly lower BMI and higher depression, anxiety, and fall risk scores, while cognitive performance did not differ between groups. Lower BMI and higher depression scores were independently associated with nutritional impairment. Regional structural measures were not significantly associated with nutritional status. CONCLUSIONS: Nutritional impairment in bvFTD appears to be independent of global cognitive status and is associated with emotional and functional vulnerability. These findings suggest that nutritional impairment reflects a multidimensional process involving emotional, behavioral, metabolic, and neurobiological mechanisms rather than a purely behavioral phenomenon.