Frontal Assessment Battery

Purpose
The FAB is a brief tool that can be used at the bedside or in a clinic setting to assist in discriminating
between dementias with a frontal dysexecutive phenotype and Dementia of Alzheimers Type (DAT!
The FAB has validity in distinguishing Fronto"temporal type dementia from DAT in mildly demented
patients (##$% & '(! Total score is from a maximum of )*+ higher scores indicating better
performance!
1. Similarities (conceptualization)
,-n what way are they ali.e/0
A banana and an orange
(-n the event of total failure1 ,they are not ali.e0 or partial failure1 ,both have peel+0 help the patient by
saying1 ,both a banana and an orange are fruit02 but credit 3 for the item2 do not help the patient for the
two following items
A table and a chair
A tulip+ a rose and a daisy
Score (only category responses 4fruits+ furniture+ flowers5 are considered correct
Three correct1 6 Two correct1 ' 7ne correct1 ) 8one correct1 3
2. Lexical fluency (mental flexibility)
,$ay as many words as you can beginning with the letter 9$+ any words except surnames or proper
nouns!0
-f the patient gives no response during the first : seconds+ say1 ,for instance+ sna.e!0 -f the patient
pauses )3 seconds+ stimulate him by saying1 ,any word beginning with the letter 9$! The time allowed is
;3 seconds!
Score (word repetitions or variations 4shoe+ shoema.er5+ surnames+ or proper nouns are not counted as
correct responses
& < words1 6 ; "< words1 ' 6 ": words1 ) = 6 words1 3
3. otor series !Luria" test (pro#rammin#)
,>oo. carefully at what -m doing!0
The examiner+ seated in front of the patient+ performs alone three times with his left hand the series of
,fist?edge?palm!0
,8ow+ with your right hand do the same series+ first with me+ then alone!0
The examiner performs the series three times with the patient+ then says to him@her1
,8ow+ do it on your own!0
Score
Aatient performs six correct consecutive series alone1 6
Aatient performs at least three correct consecutive series alone1 '
Aatient fails alone+ but performs three correct consecutive series with the examiner1 )
Aatient cannot perform three correct consecutive series even with the examiner1 3
$. %onflictin# instructions (sensiti&ity to interference)
,Tap twice when - tap once!0
To ensure that the patient has understood the instruction+ a series of 6 trials is run1 )")")!
,Tap once when - tap twice!0
To ensure that the patient has understood the instruction+ a series of 6 trials is run1 '"'"'!
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The examiner then performs the following series1 )")"'")"'"'"'")")"'!
Score 8o errors1 6 ) "' errors1 ' & ' errors1 )
Aatient taps li.e the examiner at least four consecutive times1 3
'. (o)*o (o (in+ibitory control)
,Tap once when - tap once!0
To ensure that the patient has understood the instruction+ a series of 6 trials is run1 )")")!
,Do not tap when - tap twice!0
To ensure that the patient has understood the instruction+ a series of 6 trials is run1 '"'"'!
The examiner then performs the following series1 )")"'")"'"'"'")")"'!
Score 8o errors1 6 ) "' errors1 ' & ' errors1 )
Aatient taps li.e the examiner at least four consecutive times1 3
,. Pre+ension be+a&iour (en&ironmental autonomy)
,Do not ta.e my hands!0
The examiner is seated in front of the patient! Alace the patients hands palm up on his .nees! Fithout
saying anything or loo.ing at the patient+ the examiner brings his own hands close to the patients hands
and touches the palms of both the patients hands+ to see if he will spontaneously ta.e them! -f the
patient ta.es the examiners hands+ try again after as.ing the patient1 ,8ow+ do not ta.e my hands!0
Score
Aatient does not ta.e the examiners hands1 6
Aatient hesitates and as.s what he@she has to do1 '
Aatient ta.es the hands without hesitation1 )
Aatient ta.es the examiners hand even after he@she has been told not to do so1 3
-nterpretin# results
A cut off score of )' on the FAB has a sensitivity of GGH and specificity of *GH in differentiating
between frontal dysexecutive type dementias and DAT
.eferenceS
Dubois+ B! 2 >itvan+ -!2 The FAB1 A frontal assessment battery at bedside! 8eurology! ::())1 );')");';+
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$lachevs.y+ A2 Dubois+ B! Frontal Assessment Battery and Differential Diagnosis of Frontotemporal
Dementia and Alzheimer Disease! Archives of 8eurology! ;)(G1 ))3("))3G+ '33(!
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