What is Frontotemporal Dementia (FTD)
Frontotemporal dementia is a rare, progressive brain disorder that causes memory loss. FTD describes a range of diseases that often start with changes in behavior, speech, and thinking.
As FTD progresses, it affects short-term memory. Over time, FTD causes the frontal and temporal anterior lobes of the brain to shrink. These are the parts of the brain that control behavior and speech.
There are three main types of FTD:
- Behavioral variant FTD. This is the most common type and was previously called Pick disease.
- Progressive agrammatic aphasia.
- Semantic variant primary progressive aphasia.
FTD is one of the most common causes of progressive memory loss in people younger than 60 years. The disease progresses faster in some people than in others. In some families, FTD can be associated with amyotrophic lateral sclerosis (ALS). There is no cure for FTD, but treatment and supportive care can improve a person’s quality of life.
What are the causes?
The exact cause of this condition is not known, although many genetic mutations are known to cause the disease.
What increases the risk?
This condition is more likely to occur in people who have a family history of FTD. Family members of people with FTD should think about genetic counseling.
What are the signs or symptoms?
Signs and symptoms of FTD usually start between the ages of 55–65 years. Symptoms may include:
- Impulsive, poorly controlled, inappropriate, or embarrassing behavior.
- Lack of motivation and interest (apathy).
- Irritability and agitation.
- Neglect of personal hygiene.
- Withdrawal.
- Inappropriate crying or laughing (pseudobulbar affect).
- Repetitive behaviors.
- Impulsive eating
- Lack of concern for others.
- Failure to recognize behavioral changes.
- Loss of the ability to speak fluently.
- Inability to write or read.
- Slurred speech.
- Loss of vocabulary.
- New drug or alcohol abuse.
Short-term memory loss is also a symptom later in the disease.
How is this diagnosed?
Your health care provider may suspect FTD if you have worsening behavior or speech difficulties. You may need to see specialists in brain and behavioral health who will collect your medical history and do a neurological examination. The following tests may be done:
- Blood tests to rule out other causes, like vitamin deficiency, harmful effects of substances (toxicities), and infections.
- Spinal tap (lumbar puncture) to check spinal fluid samples for abnormal proteins.
- Imaging tests, such as a CT scan, PET scan, or MRI. These can show brain changes that suggest FTD or another brain disorder.
- Memory testing (neuropsychological testing), which involves several hours of standardized tests to check the many functions of the brain.
How is this treated?
There is no cure for this condition and the progression of FTD cannot be stopped. Support at home is the most important aspect of managing FTD. Ask about caregiving resources in your community.
Management of this condition may include:
- Antidepressants to help with apathy.
- Medicines to treat pseudobulbar affect.
- Sedative medicines to control aggressive or dangerous behavior.
- Speech and language therapy.
- Behavioral therapy.
- Occupational therapy to help with home safety and activity.
Institutional or supportive care may eventually be needed.
Follow these instructions at home:
Eating and drinking
- Follow a healthy diet. Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
- Avoid having too much sugar and caffeine in your diet.
- Watch for signs of compulsive eating, which can lead to other health problems.
- Do notdrink alcohol.
- Drink enough fluid to keep your urine pale yellow.
Lifestyle
- Keep a regular routine.
- Avoid stress and new situations.
- Avoid any activities that may trigger aggressive behavior.
- Schedule regular, enjoyable, and supervised physical activity.
General instructions
- Take over-the-counter and prescription medicines only as told by your health care provider.
- If you were given a bracelet that tracks your location, make sure you wear it.
- Work with your health care provider to determine what you need help with and what your safety needs are.
- Keep all follow-up visits, including any therapy visits, as told by your health care provider. This is important.
Contact a health care provider if:
- Your symptoms change or get worse.
- It becomes more difficult or stressful to be cared for at home.
Get help right away if:
- It is no longer possible to be cared for at home.
- You or your family members become concerned for your safety.
Summary
- Frontotemporal dementia (FTD) is a rare, progressive brain disorder that causes memory loss.
- There is no cure for this condition and the progression of FTD cannot be stopped.
- Support at home is the most important aspect of managing FTD. Ask about caregiving resources in your community.
- Work with your health care provider to determine what you need help with and what your safety needs are.
