FTD Dementia: Signs, Symptoms, And Treatments
There are various types of dementia that an individual might be diagnosed with. Dementia itself is an umbrella term to describe frontotemporal dementia and other forms of dementia. Frontotemporal dementia may be referred to as FTD. FTD is an umbrella term for cognitive conditions that can cause memory loss, difficulty making decisions, and other challenging symptoms. If you or a loved one are living with FTD dementia, there are various signs, symptoms, and treatments to consider.
What is FTD dementia?
Frontotemporal dementia, also known as FTD or FTD, is a group of diseases that often affect younger individuals than other types of dementia, such as Alzheimer’s disease. The National Institute on Aging estimates that approximately 60% of individuals experiencing FTD are between the ages of 45 and 64. These diseases, which can affect the frontal and temporal lobes of the brain, may reduce a person's life expectancy.
While symptoms can vary, some individuals diagnosed with FTD can live over 10 years after their diagnosis, while others may survive less than two. Although this condition has no cure, early recognition and treatment of FTD may slow its progression.
What are the different types of FTD disorders?
The National Institute on Aging suggests that there are three subtypes of FTD: primary progressive aphasia (PPA), movement disorders, and behavioral variant frontotemporal dementia (bvFTD).
Primary progressive aphasia (PPA)
Primary progressive aphasia (PPA) can often manifest as communication difficulties, specifically in the way a person speaks, writes, reads, and understands others. Aphasia, or difficulty comprehending or using words, is a common symptom of PPA, as are other speaking difficulties, such as slurring speech.
In some cases, an individual with PPA may be unable to speak entirely. Those with PPA can also develop common dementia symptoms, such as difficulties with memory, reasoning, and judgment. These symptoms may appear subtle at first and increase over time. Depending on the language challenges an individual encounters, they may experience one of three types of PPA, including the following.
Agrammatic PPA
Agrammatic PPA, also known as nonfluent variant PPA, can impair a person’s ability to pronounce certain words or use proper grammar. Due to these impairments, an individual with agrammatic PPA may take more time formulating sentences, leaving out words from a sentence, or speaking slower. Agrammatic PPA may also cause a person to struggle to control their tongue, jaw, and lips, which can further complicate the pronunciation of certain words.
Logopenic PPA
Unlike individuals with agrammatic PPA, those experiencing logopenic PPA may not struggle with grammar. However, they might find it challenging to remember the correct words or speak in longer sentences. In addition, those with logopenic PPA may make mistakes during speech or substitute certain sounds for others while still understanding words and sentences.
Semantic PPA
Semantic PPA may cause an individual to struggle with the meaning of specific words. As a result, these individuals may use more general terms to describe items or situations. For example, instead of saying “pancakes,” they may say “food.” In addition, those with semantic dementia may find it challenging to remember the names or faces of familiar people. As the condition progresses, they may also find it difficult to understand conversations.
Movement disorders
While often rare, FTD may also be associated with several types of movement disorders, including progressive supranuclear palsy and corticobasal syndrome.
Progressive supranuclear palsy
Progressive supranuclear palsy may also cause a person to struggle with eye movements. While specific movement challenges can vary, some might find it difficult to look down or avoid locking into a fixed stare. As this disorder develops, it may affect a person’s judgment, memory, problem-solving ability, and overall behavior.
Corticobasal syndrome
Those who experience nerve cell atrophy in specific brain regions may develop a degenerative movement disorder known as corticobasal syndrome. This syndrome can lead to apraxia, a symptom that can negatively impact one’s ability to complete particular arm or hand movements, as well as difficulty swallowing and muscle rigidity.
While the signs of corticobasal syndrome can vary, some may notice difficulty speaking or orienting objects, with movement symptoms developing later. However, not everyone who experiences this syndrome will struggle with speaking or notice challenges with cognition, behavior, or memory.
In addition to these types, FTD may also be associated with other movement-related disorders, such as frontotemporal disorders with parkinsonism and frontotemporal dementia with amyotrophic lateral sclerosis. However, they, too, can be less common than other subtypes.
Behavioral variant frontotemporal dementia (bvFTD)
According to the Association for Frontotemporal Degeneration, bvFTD is responsible for approximately 50% of all cases of frontotemporal dementia, making it the most common form of neurological disorders causing dementia. This type of FTD is often characterized by changes in personality, apathy, judgment, self-control, empathy, and social behavior.
An individual experiencing bvFTD may not be aware of these changes or show concern about their potential impact. Those with bvFTD may also become disinhibited, which could lead them to break societal norms or act in uncharacteristic ways. This behavior can potentially manifest as invading the personal space of others, making inappropriate comments, or engaging in offensive behavior in public.
BvFTD may also cause a person to change their habits or engage in compulsive behaviors. This behavior may involve excessive consumption of liquids, refusing to eat anything but a single type of food, repeating words or movements numerous times, or consuming the same piece of media multiple times. Individuals with bvFTD can also struggle with executive function and emotional instability. These challenges may lead to frequent changes in mood, frustration, and difficulty with decision-making and judgment.
How is FTD dementia diagnosed?
If you recognize the signs or symptoms of one of these types of FTD dementia, contact a medical professional to receive an official diagnosis. After an initial assessment with a primary care physician, individuals are often referred to a neurologist for a thorough examination. These specialists may run blood tests, ask about family history, and rule out other conditions that can present with similar symptoms, such as obstructive sleep apnea and certain types of infections.
From there, neuropsychological testing may be used to rule out psychiatric conditions that may explain symptoms. Brain imaging techniques, including magnetic resonance imaging (MRI scans), may also be used to rule out physical conditions, such as subdural hematomas, tumors, hydrocephalus, and small vessel ischemia. Lumbar puncture tests may be used to test for immune system disorders and carcinomatous and paraneoplastic syndromes. After testing, an official diagnosis and treatment plan may be provided.
What treatments are effective for FTD dementia?
While there is no cure for FTD dementia, the UK National Health Service (NHS) recommends a combination of medication and different forms of therapy to treat FTD symptoms. While medication may not slow the progression of FTD, certain options could alleviate symptoms like depression, anxiety, and stress. Others may make managing symptoms more accessible or slow the progression of a condition.
The NHS suggests that selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, may help individuals experiencing compulsive behaviors or loss of inhibitions. In addition, antipsychotics may be used if SSRIs are not effective, though the NHS notes their usage is rare. In addition to medications, certain types of mental and physical therapy may also be beneficial for those experiencing dementia, including the following.
Physiotherapy
Physiotherapy is a form of treatment that can address the physical effects of dementia, such as changes in movement, reduced mobility, and pain. This treatment may involve implementing an exercise program, which could improve cognition, memory, mental health, and overall well-being.
Speech and language therapy
Speech and language therapy may help individuals work on their communication skills. For individuals with dementia, this type of therapy can address struggles with remembering specific words, paying attention during conversations, and listening when others are speaking. Speech and language therapy may also help with certain physical aspects of FTD, such as difficulty swallowing.
Occupational therapy
Occupational therapists may address the difficulty individuals with FTD often experience when attempting to perform daily tasks. By identifying which tasks a person is struggling with and finding creative solutions to complete them, occupational therapists may help individuals with dementia maintain a sense of independence.
Alternative support options
While the above and other therapeutic approaches may be effective for individuals with dementia or their family members, some may find it challenging to access in-person therapy. For family caregivers of those with dementia, it may be difficult to find time to commute to an in-person therapy session. Alternative therapeutic formats, such as online therapy through a platform like BetterHelp, may allow these individuals to attend sessions from their own homes while staying close to those they are caring for.
Through an online platform, individuals have more control over how and when they receive support. For example, clients can choose between phone, video, or live chat sessions and pick a time that fits their schedule, including outside of standard business hours.
Research indicates that online therapy can be as effective as in-person therapy. A 2021 meta-analysis reviewed over 100 studies with thousands of participants to determine the outcome differences between these two types of therapies. They found that online psychotherapy led to substantial and significant improvement in various disorders, including anxiety, depression, and post-traumatic stress disorder (PTSD). In addition, the results of this study indicated that the treatment outcomes differed negligibly from in-person therapy, suggesting that therapy is no less efficacious when delivered via videoconferencing.
Takeaway
If you recognize the symptoms of these disorders in yourself or a loved one, consider talking to your primary care physician for a referral and diagnosis. Once diagnosed, it may be possible to start treatment to manage symptoms, which could involve the use of medication and various types of therapy. You can also consider reaching out to a therapist online or in your area to talk about the mental health challenges of living with dementia or caring for someone with the condition.
What is the life expectancy of someone with frontotemporal lobe dementia?
According to the National Institute of Health (NIH), people with frontotemporal lobe dementia have an average life expectancy of about six to eight years. The disease progression may be longer or shorter. There is no one way to know when someone might pass from this condition as the disease progresses. Only a doctor can diagnose frontotemporal dementia and give a prognosis.
What are the behaviors of frontal lobe dementia?
People with frontotemporal lobar degeneration often display noticeable symptoms like unusual behaviors. These behavioral symptoms might include compulsive eating, loss of language skills, agitation, strange speech, aggression, running away, or becoming unresponsive to the environment. Often, frontotemporal dementia affects language abilities the most, causing individuals to develop progressive nonfluent aphasia, a speech disorder that causes trouble communicating. Language symptoms are often treated with speech therapy and mental health support. Physical and occupational therapy may also be helpful for behavioral variant FTD.
What are the first symptoms of FTD?
The first noticeable symptoms of an FTD diagnosis are usually behavioral and mental health-related.Certain behavioral symptoms may first be misidentified as a mental health condition, as they can look like depression, apathy, and complete personality changes. Over time, muscle weakness and poor coordination can also show up. If you notice these changes in yourself or someone you love, reach out to a doctor for a neurological exam or consult. They may refer you for genetic tests, brain scans, or other healthcare providers to look at whether dementia or other brain disorders are causing your symptoms. However, only genetic tests can fully confirm if you have FTD or motor neuron disease.
How quickly does FTD progress?
FTD progresses fairly quickly over the span of six to eight years until the end of the disease. To help you manage FTD symptoms and track disease progression, talk to your neurologist about your prognosis and plan for treatment. Over time, FTD progresses to body stiffness and muscle stiffness that can be difficult to cope with. You can talk to your care team about how to manage this symptom and others by connecting with your doctor and exploring expectations as you or someone you love experiences this condition.
Can frontotemporal dementia go away?
Frontotemporal dementia does not have a cure at this time. There are clinical trials in effect to always look for opportunities for a cure, but for now, the treatment for this condition is usually hospice and respite care. Because a prominent symptom of this condition is loss of brain cells in the frontotemporal lobe, people with this condition often require supervision, support, and caregiving. People may also qualify for Social Security disability benefits (SSDI). If you or a loved one has this condition, you may also consider telling the doctor about your family medical history, as conditions like FTD and Lou Gehrig’s disease can be passed down to children. Generally, those at a younger age don’t show symptoms, so you might consider a genetic test if you’re the child of someone with FTD.
Who is most likely to get frontotemporal dementia?
Those most likely to get frontotemporal dementia are those who have a parent or close family member with the condition or those who have a positive genetic marker for the condition. Not everyone with the genetic marker will develop dementia, however. You can take steps to make positive lifestyle changes to prevent dementia throughout your life, such as frequent exercise, nutritious eating, drinking water, and having healthy relationships.
What triggers frontotemporal dementia?
The exact cause of FTD is unknown, though many researchers have done tests like a brain autopsy to learn about what might cause this condition. Often, proteins called tau clusters are found in the brains of those with FTD. Other proteins, genetics, and family history may also lead to someone developing FTD.
What famous person has frontotemporal dementia?
Two people with FTD are Wendy Williams and Bruce Willis. Since Wendy Williams’ diagnosis, she has developed aphasia, which has lead to difficulty talking. She has since canceled her famous talk show due to her condition. Both individuals are alive as of 2024.
What do dementia eyes look like?
People with dementia may stare into the distance with an apathetic look or dissociate during a conversation. They may also have strange eye movements, such as shakiness in their eyes. Some people have retinal or pupil changes. Others may experience visual hallucinations, which are visual stimuli only they can see.
Do people with FTD sleep a lot?
Some people with FTD sleep a significant amount of time, whereas others may have difficulty falling or staying asleep. If you or a loved one is having sleep troubles, talk to a doctor as soon as possible. Sleep deprivation can have detrimental impacts on mental and physical health, which may worsen someone’s FTD symptoms.
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