often more severely impaired relatively early in the course . For individuals with the be-
havioral variant, prior to diagnostic clarific ation there may be significant family disrup-
tion, legal involvement, and problems in the workplace because of socially inappropriate
behaviors. The functional impairment due to  behavioral change and language dysfunc-
tion, which can include hyperorality, impuls ive wandering, and other dishinhibited be-
haviors, may far exceed that due to the co gnitive disturbance and may lead to nursing
home placement or institutionalization. Thes e behaviors can be severely disruptive, even
in structured care settings, particularly wh en the individuals are otherwise healthy, non-
frail, and free of othe r medical comorbidities. 
Differential Diagnosis
Other neurocognitive disorders. Other neurodegenerative diseases may be distinguished
from major or mild frontotemporal NCD by th eir characteristic features. In major or mild
NCD due to Alzheimer’s disease, decline in learning and memory is an early feature.
However, 10%–30% of patients presenting with  a syndrome suggestive of major or mild
frontotemporal NCD are found at  autopsy to have Alzheimer’s disease pathology. This oc-
curs more frequently in individuals who present with progressi ve dysexecutive syn-
dromes in the absence of behavioral changes or movement disorder or in those with the
logopenic variant.
In major or mild NCD with Lewy bodies, co re and suggestive features of Lewy bodies
must be present. In major or mild NCD due to Parkinson’s disease, spontaneous parkin-
sonism emerges well befo re the cognitive decline. In majo r or mild vascular NCD, depend-
ing on affected brain regions, there may also  be loss of executive ability and behavioral