What is Frontotemporal Dementia?

What is frontotemporal dementia

Getty Dutch Queen Maxima meets one of the residents after the opening of the Hof van Nassau nursing home in Steenbergen on May 28, 2019. The nursing home offers maximum freedom to its residents with dementia.

Frontotemporal dementia, or frontotemporal lobar degeneration, is an umbrella term for a wide-ranging group of disorders that affect the frontal and temporal lobes of the brain. These disorders are uncommon, and often cause changes in personality, behavior and language because of the affected area of the brain.

Portions of these lobes shrink or atrophy, according to the Mayo Clinic.

The frontal lobes are the areas behind the forehead, and the temporal lobes are the areas behind the ears.

“The nerve cell damage caused by frontotemporal dementia leads to loss of function in these brain regions, which variably cause deterioration in behavior, personality and/or difficulty with producing or comprehending language,” according to the Alzheimer’s Association.

The disease was originally called Pick’s Disease, and some doctors still refer to it this way. It was named for Dr. Arnold Pick in 1892 who observed a patient with difficulties with language.

The disease can also cause problems with motor skills. Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease, is a part of the frontotemporal degeneration spectrum.

While there are treatments to reduce agitation and improve quality of life in FTD patients, there are no specific treatments.

“Only rough estimates are available, but there may be 50,000 to 60,000 people with behavior variant frontotemporal dementia and PPA in the United States, the majority of whom are between 45 and 65 years of age,” according to the Alzheimer’s Association.

Here’s what you need to know:

Frontotemporal Dementia Can Cause Personality Changes & Socially Inappropriate Behaviour or Difficulties With Language

Frontetemporal dementia can cause a loved one to seemingly disappear. FTD is a type of dementia that can cause huge changes in a person’s personality, or can even cause the person to begin engaging in socially inappropriate behavior, according to the Mayo Clinic.

“Some people with frontotemporal dementia undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use language,” the Mayo Clinic said.

This is the most common type of FTD.

“In behavior variant frontotemporal dementia, the nerve cell loss is most prominent in areas that control conduct, judgment, empathy and foresight, among other abilities,” according to the Alzheimer’s Association.

Another type of FTD effects language skills, speaking, writing and comprehension, while a second type causes problems with personality or behavior.

Frontotemporal Dementia Can Be Misdiagnosed as a Psychiatric Problem or Alzheimer’s Disease

Because of the effects of Frontotemporal Dementia, it can often be misdiagnosed. Sometimes it is misdiagnosed as Alzheimer’s disease, and other times FTD is misdiagnosed as a psychiatric disorder. This can occur because FTD can cause personality changes in a person, cause the person to act emotionally indifferent or impulsive, or even become socially inappropriate, according to the Mayo Clinic.

Changes in personality or behavior typically lead to the diagnoses, whereas Alzheimer’s disease is generally noticed because of memory problems. People with Alzheimer’s are also typically diagnosed later in life.

“The diagnosis of behavior variant frontotemporal dementia and PPA are based on expert evaluation by a doctor who is familiar with these disorders. The type of problems experienced by the patient and the results of neurological exams are the core of the diagnosis. Brain scans such as magnetic resonance imaging (MRI) and glucose positron emission scans are very helpful additional tests, but they must be interpreted in the context of the patient’s history and neurological exam,” according to the Alzheimer’s Association.

Frontotemporal Dementia Often Occurs at a Younger Age Than Alzheimer’s Disease

Unlike Alzheimer’s disease, Frontotemporal dementia often occurs when a patient has barely reached middle age, according to the Mayo Clinic.

“…frontotemporal dementia tends to occur at a younger age than does Alzheimer’s disease, generally between the ages of 40 and 45,” the Mayo Clinic said.

According to the Alzheimer’s Association, people can be diagnosed with the disease when they are as young as 20, or as old as their late 80s.

“Frontotemporal dementia inevitably gets worse over time and the speed of decline differs from person to person. For many years, individuals with frontotemporal dementia show muscle weakness and coordination problems, leaving them needing a wheelchair — or bedbound. These muscle issues can cause problems swallowing, chewing, moving and controlling bladder and/or bowels. Eventually people with frontotemporal degenerations die because of the physical changes that can cause skin, urinary tract and/or lung infections,” according to the Alzheimer’s Association.

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