What Is Frontotemporal Dementia?

The term ‘frontotemporal dementia’ refers to a group of brain disorders that result from brain cell loss in the frontal and temporal lobes. As a result, these lobes start to shrink in size. This can cause major challenges as these areas of the brain are linked to language, behavior, and personality. [1] Frontotemporal dementia has recently started to enter public discussion due to actor Bruce Willis’ recent diagnosis. Many people were left with questions after witnessing their beloved action hero lose his ability to communicate and function as he once had. As more people become aware of this condition, it is important to gain a clearer understanding of what it is and how it affects people. 

Understanding Frontotemporal Dementia

Frontotemporal dementia causes the lobes to shrink, a process known as atrophy. The individual’s symptoms are dependent on which area of their brain is affected by the disease. Some individuals lose their ability to communicate properly. Others exhibit drastic changes in their personalities. They often become impulsive, apathetic, and socially inappropriate. In many cases, frontotemporal dementia is initially misdiagnosed as Alzheimer’s disease or other mental conditions. However, unlike Alzheimer’s, this condition often begins at a younger age, typically between the ages of 40 and 65. [2]

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Types of Frontotemporal Dementia

There are two main types of frontotemporal dementia: behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA). BvFTD affects the patient’s behavior and personality, resulting in noticeable changes in how someone acts. This typically occurs in middle age. PPA affects a person’s language skills such as speaking, comprehension, and writing. There are two types of PPA: one type makes it hard for the person to understand or form sentences, while the other type makes speech slow and difficult. Certain individuals also develop mobility issues, such as ALS or other conditions that cause problems with coordination. [3]

The Symptoms of Frontotemporal Dementia

There are a range of symptoms associated with this condition, and they typically vary from one individual to another. Patients usually suffer from clusters of symptoms that occur simultaneously. Behavioral changes include a lack of judgment and inhibitions, a lack of empathy and apathy, compulsive and inappropriate behaviors, and a decline in personal hygiene. Speech and language changes include increased difficulty in understanding spoken and written language, trouble naming objects and forgetting the meaning of certain words. Mobility symptoms include rigidity, poor coordination, muscle spasms, weakness, difficulty swallowing, and walking issues. [2]

The Causes of FTD

While much is understood about how frontotemporal dementia develops in the brain, there is still little data on why this condition affects some people and not others. For instance, there is not enough evidence to indicate whether certain lifestyle choices can increase your risk. However, they are aware of a few factors that increase your chances of developing frontotemporal dementia. For example, it is more likely to be caused by genes than other types of dementia. This can be traced to a single faulty gene that is passed down from parent to child, known as ‘familial FTD’. Around 10 in every 100 individuals diagnosed with FTD have this type. [4] 

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Diagnosis of Frontotemporal Dementia

Frontotemporal dementia is often difficult to diagnose because it shares so many similar symptoms to other conditions. For instance, some doctors misdiagnose bvFTD as a mood disorder. It becomes even more confusing when a patient suffers from multiple types of dementia. During a diagnosis, a doctor will typically perform an examination of the patient and inquire about their symptoms. They will then look into their personal and family medical history. Laboratory tests are then used to rule out other potential causes. Often they will conduct various tests to assess the patient’s language skills, memory, and physical functioning. They also typically order genetic tests and brain imaging. [5]

Management and Treatment

At the present moment, there is no cure for this condition and no way to slow it down or prevent it in the first place. Thankfully though, there are ways that help manage the symptoms of frontotemporal dementia. When it comes to managing behavioral symptoms, it is best to rather accept the situation than try and challenge the person. They cannot control their behavior, so trying to reason or argue with them is both pointless and frustrating. Patients find it difficult to respond to complex questions, so instead of asking what they would like to do that day, give them two options to choose from. While there is no cure for this condition, there are medications available that treat certain behavioral symptoms. Dealing with an individual with frontotemporal dementia can often prove very challenging, so take a time out for a few minutes if you start to feel overwhelmed or frustrated. [6]

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