Frontotemporal dementia (FTD) is a neurodegenerative disease that damages neurons in the frontal and temporal lobes of the brain, causing symptoms and signs such as behavioral changes, apathy, and difficulty understanding words and/or speaking.
Also known as frontotemporal disorders, the exact causes of frontotemporal dementia are still not fully understood. It typically develops in people between the ages of 45 and 65.
If frontotemporal dementia is suspected, it is recommended to see a neurologist or primary care doctor for a complete evaluation and to determine the most appropriate treatment. Treatment may involve medications, physical therapy, and occupational therapy.
Symptoms and types of frontotemporal dementia
Depending on the type of frontotemporal dementia, the main symptoms include:
1. Behavioral variant
Symptoms of the behavioral variant include:
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Difficulty prioritizing tasks or activities
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Repeating the same activity or saying the same word over and over
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Acting impulsively
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Saying or doing inappropriate things
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Losing interest in family or activities they used to enjoy
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Showing flat, exaggerated, or inappropriate emotions for the situation
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Eating compulsively or taking food from other people's plates
The behavioral variant is the most common type of frontotemporal dementia, characterized by changes in personality, behavior, and judgment. Over time, a person with this type of FTD may also develop language and/or movement problems.
2. Semantic variant
In this type of frontotemporal dementia, the person generally experiences vocabulary loss and difficulty understanding or finding words. Other possible symptoms include impaired comprehension, trouble recognizing objects or unfamiliar faces, nonsensical speech, and memory loss.
3. Primary progressive aphasia
In this type of frontotemporal dementia, the person has changes in their ability to communicate. The main symptoms of primary progressive aphasia include:
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Loss of the ability to understand individual words
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Difficulty speaking and leaving out connecting words between nouns and verbs
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Loss of the ability to recognize familiar faces and common objects
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Trouble finding the right words during a conversation
In advanced stages, people with this type of frontotemporal dementia may eventually lose the ability to speak.
Confirming a diagnosis
The diagnosis of frontotemporal dementia should be made by a neurologist or primary care doctor through a clinical evaluation. Doctors often recommend imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans.
Other tests that may be ordered include a complete blood count (CBC) and neurological assessments such as the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Functional Cognitive Assessment.
Possible causes
The causes of frontotemporal dementia are not well defined. However, it is believed that the disease is related to mutations in specific genes associated with Tau protein and TDP-43 protein.
These protein mutations may be caused by genetic factors. In addition, people who have suffered a traumatic brain injury may experience brain changes that can lead to frontotemporal dementia.
Treatment options
Treatment for frontotemporal dementia typically involves medications, physical therapy, speech therapy, and occupational therapy.
1. Medications
Some medications that may be prescribed by the doctor to help manage the symptoms of frontotemporal dementia include anticonvulsants, antidepressants, and antiepileptic drugs.
2. Physical therapy
Physical therapy sessions may be recommended to help the person perform daily activities such as walking, swallowing, chewing, and controlling the bladder or bowels.
3. Occupational therapy
Occupational therapy sessions are used to develop or restore motor skills such as eating, walking, dressing, and bathing. Occupational therapists can also teach the person to use assistive devices like special utensils, walkers, or wheelchairs.
4. Speech therapy
Speech therapy is mainly recommended for people with language problems. Speech-language pathologists can use alternative communication methods such as electronic devices or picture books.
How does frontotemporal dementia differ from Alzheimer’s disease?
Although they have similar symptoms, frontotemporal dementia usually appears between ages 45 and 65, unlike Alzheimer’s disease, which is most often diagnosed in people over 65.
In addition, people with frontotemporal dementia more commonly have behavioral and language problems and fewer memory problems compared to those with Alzheimer’s disease. Memory loss in FTD generally occurs in the later stages.
Is frontotemporal dementia curable?
Frontotemporal dementia currently has no cure, and there is no treatment available to slow or prevent the disease. However, medical treatments can help manage the symptoms of this condition.