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.
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