Frontotemporal Dementia: Symptoms, Causes & Treatment

Updated in December 2023

Frontotemporal dementia is a disorder that affects the frontal and temporal lobes of the brain, leading to changes in personality and behavior, as well as difficulty understanding and producing speech. 

This type of dementia is one of the common types of neurodegenerative diseases. These conditions tend to worsen with time, and their onset can be noted between the ages of 45 and 65. It is a genetic disease, meaning that DNA modifications are passed on from parent to child. 

Treatment for frontotemporal dementia involves the use of medications that reduce symptoms and improve overall quality of life. Unfortunately, there is no cure for this disease and its pathology worsens over time. 

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Main signs and symptoms

The main signs and symptoms of frontotemporal dementia are: 

Behavioral symptoms

  • Personality changes 
  • Impulsivity and loss of inhibition 
  • Aggressive attitudes and irritability
  • Lack of interest in other people
  • Repetitive movements or tasks
  • Preference for very sweet or fatty foods 

Speech-related symptoms

  • Difficulty speaking or writing
  • Problems understanding when spoke to
  • Forgetting the meaning of words 
  • Difficulty recognizing faces
  • Loss of ability to articulate words 

Motor symptoms

  • Tremors, rigidity and muscular spasms 
  • Difficulty swallowing or walking
  • Loss of arm of leg movements
  • Urinary or fecal incontinence 

These symptoms are usually reported by family or close friends, as patients are unable to recognize changes to their personality or behavior.

Patients can present with several symptoms or just some of these. Generally, they start off mild and worsen with time. 

Possible causes

The causes of frontotemporal dementia are not well known, however some studies show that it may be associated with changes to specific genes and their connection to TAU protein and TDP43 protein. These proteins are naturally-occurring in the body, and help cells to function correctly. For reasons yet unknown, these proteins appear to accumulate in different areas of the brain, leading to changes in motor function, language and behavior. 

Protein mutations can be triggered by genetic factors, meaning that people with a family history of dementia are more likely to develop similar brain disorders. People with a history of traumatic brain injury are also more likely to develop frontotemporal dementia. 

Confirming a diagnosis 

It is important to consult a neurologist if you suspect any signs or symptoms of dementia. The doctor will complete a clinical assessment and order further testing, such as: 

  • Imaging exams: like MRI or CT to visualize the part of the brain that may be affected 
  • Neuropsychological tests: which are designed to determine memory capacity and identify behavioral or speech-related changes
  • Genetic tests: which consist of blood tests to analyze protein types and DNA 
  • Lumbar puncture: to collect cerebrospinal fluid and identify which nervous system cells are affected 
  • Complete CBC: which is ordered to rule out other conditions that may present with similar symptoms 

If the neurologist suspects other health conditions, like a brain tumor or brain clot, other tests can additionally be ordered, like a PET scan, brain biopsy or brain scintography. 

Treatment options

Frontotemporal dementia treatment is aimed at reducing negative symptoms, improving quality of life and extending life expectancy. There are still no medications or surgery available to completely cure this disease. Some medications, like anticonvulsants, antidepressants and anti-epileptics can be used to manage symptoms.

Including family and caregivers is also an important aspect of treatment. Some recommendations include reducing environmental stimuli and opting for less stressful activities. These patients are encouraged to co-habitate with a small group of people and to participate in regular exercise, as well as cognitive behavioral psychotherapy. 

As this disease evolves, patients may have more difficulty walking, swallowing, chewing and even controlling their bladder or bowel movements. These patients may be prescribe physiotherapy and speech therapy to maintain these activities of daily living. 

Difference between frontotemporal dementia and Alzheimer’s disease 

Although their symptoms appear to be similar, frontotemporal dementia does not present with the same abnormalities as Alzheimer’s disease. Most types, frontotemporal dementia is diagnosed in people between the age of 40 and 60, which differs from Alzheimer’s, which is usually diagnosed after the age of 60. 

With frontotemporal dementia, it is more common for patients to experience behavioral problems, hallucinations and delirium, which differs from the memory loss that is commonly reported among Alzheimer’s patients. With frontotemporal dementia, memory loss tends to occur in more advanced phases of the disease. 

Read more about the symptoms of Alzheimer's and complete our online symptoms quiz.