What is Frontotemporal Dementia

 

What is Frontotemporal Dementia

Frontotemporal dementia (FTD) is a group of brain disorders that affect the temporal lobes (regions behind your ears) and the frontal lobes (areas behind your forehead). These areas of the brain are affiliated with language, behavioral control, and personality. FDB occurs when part of these lobes shrinks, and nerve cells are damaged, resulting in loss of function.

Frontotemporal dementia is often misdiagnosed as a psychiatric problem, such as schizophrenia and obsessive-compulsive disease, or Alzheimer's. But FTD tends to affect younger people aged 40 to 65, which is the opposite of Alzheimer's.

Some doctors may refer to frontotemporal dementia (FTD) as frontotemporal degenerations, Pick's disease, frontotemporal disorders, or frontal lobe disorders.

Two types of frontotemporal dementia

1. Behavior variant frontotemporal dementia (bvFTD)

The nerve cell loss is very noticeable in brain areas that control judgment, empathy, foresight, conduct, and other related abilities. The condition can develop in people as young as 20 years old to 80. Notable changes in behavior and personality become very prominent at age 50 to 60.

2. Primary progressive aphasia (PPA)

This condition affects the brain areas associated with speaking, language skills, comprehension, and writing. It can occur in people below 65 years old. PPA has three forms:

  1. Semantic Variant Primary Progressive Aphasia (svPPA)

    The person loses the ability to formulate words or understand what is being said.

  2. Nonfluent/Agrammatic Variant Primary Progressive Aphasia (nfvPPA)

    The person finds it difficult to speak but can still recall the meanings of the word.

  3. Logopenic Progressive Aphasia (LPA)

    The individual has trouble thinking of words and eventually starts to speak slower.

For people over 65 years old, these types of FTD are far less common than Alzheimer's. However, for people aged 45 to 65, behavior variant frontotemporal dementia (bvFTD) and PPA are almost as common as younger-onset Alzheimer's. Of the estimated 50,000 to 60,000 Americans with FTD, the majority are between 45 and 65 years old.

Major differences between frontotemporal dementia and Alzheimer's

  1. Age

    FTD typically affects people in their 40s and early 60s. Alzheimer's commonly develops in older people.

  2. Memory Loss

    Memory loss in people with FTD occurs in the advanced stage, while the same symptoms are seen in people with early-stage Alzheimer's.

  3. Behavior changes

    Behavior changes are the first symptoms in bvFTD type of frontotemporal dementia. A person with Alzheimer's displays changes in behavior at a later stage of the disease.

  4. Hallucinations and delusions

    Both are relatively common in advanced-stage Alzheimer's but not in FTD.

The cause of LBD remains unknown. The condition isn't linked to genetics either. Up to this day, scientists are researching more about its genetics and biology.

Who is at risk

About 1 in 3 cases of frontotemporal dementia is inherited, so families with a history of dementia have a higher risk. Other than this, there are no recognized risk factors.

Symptoms

FTD affects equally both men and women, and symptoms are varying. People aged 40 to 65 may start to exhibit some indications of FTD like:

  • Changes in their personality
  • Emotional indifference, impulsiveness
  • Steady language dysfunction
  • Trouble naming things
  • Forgetting word meanings
  • Difficulty in reading and writing
  • Hesitation when speaking
  • Loss of interpersonal skills
  • Loss of inhibition
  • Lack of judgment
  • Lack of interest
  • dietary changes and poor insight
  • Eating inedible objects
  • Tremor, Poor coordination, muscle spasms,
  • Difficulty swallowing
  • poor coordination and balance

Treatment

There's no cure or known methods to reverse and prevent the damage caused by frontotemporal dementia. But certain medications can help manage symptoms and improve the quality of life.

Antidepressants and antipsychotics may help reduce anxiety and agitation. Speech and language pathologists and therapists (physical and occupational) can help adjust some of the changes caused by the condition.

People may live with FTD for years. However, FTD makes people more vulnerable to infections, and this increases the risk of health complications. Pneumonia is the leading cause of death in people with FTD.

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