Frontotemporal Dementia (FTD) is a cluster of diseases commonly diagnosed incorrectly as Alzheimer's disease. These diseases include:
- Pick's Disease
- Frontotemporal Lobar Degeneration
- Progressive Aphasia
- Semantic Dementia
Early diagnosis is important because the progression of FTD is different from AD. Unlike AD, it is rare to have the onset of FTD after 75. People with FTD have different behavioral symptoms early in the disease and appear to have a longer clinical progression. Also, people with FTD who become ill in mid-life may initially be confused with those suffering from depression; when the first signs occur in younger people, the condition may be confused with Schizophrenia or Bipolar Disorder.
General Symptoms
There are gradual and progressive changes in behavior and language function.
The first behavioral signs involve difficulty in modulating social behaviour. This may produce lack of inhibition, such as swearing, outbursts of frustration and tactlessness.
As the disease progresses, criminal behavior (e.g. shoplifting), poor financial judgment or impulsive spending may result. The impulsivity can be self-destructive, for example, climbing out of a window. Some individuals demonstrate inappropriate sexual behaviour (such as exposure).
There may also be repetitive or obsessive compulsive behaviors, including repetition of activities (e.g. reading the newspaper) or repeating certain physical actions (e.g. returning to the same location).
Eating may be problematic. Overeating may occur as well as food obsessions. The person may also demonstrate lack of concern about personal appearance, becoming progressively unkempt.
People with FTD usually indicate little insight into their actions.
Despite reported memory loss, these individuals can remember everyday events. Some may even develop new skills in music and art.
Language symptoms
Early deterioration in language skills (speech, reading and writing) is a rarer version of FTD. Many individuals demonstrate problems with naming objects or expressing themselves well. Difficulties with reading and writing develop later. Understanding of word meaning remains relatively good.
As the disease progresses, less language is used, until the person may not speak at all. Sometimes, there is difficulty with naming and with understanding words.
People with AD may show apathetic behaviour in situations that are confusing and overwhelming to them, whereas apathy in FTD patients is more pervasive reflecting lack of concern for others, or is sometimes a generalized lack of initiative and passivity.
When AD and FTD are in the advanced stages, they often appear similar. What distinguishes them is the course taken to reach this advanced stage of brain dysfunction.
Genetics
40% of FTD has a genetic component. The majority of cases in which genes are involved follow an autosomal dominant inheritance pattern. Thus, 50% of the children of an affected individual are at risk for developing FTD. The presence of the disease within families is variable. Some people may have FTD alone while others may develop ALS (Lou Gehrig's disease), Parkinsonism, or psychiatric symptoms.
Analysis of family medical and social history can clarify whether an affected person has a sporadic or hereditary form of FTD. Even when a family exhibits autosomal dominant inheritance of FTD, the exact genetic cause may not be known.
Evaluation
Imaging and neuropsychological tests can be used to evaluate FTD. One of the most useful tests in the evaluation of FTD is magnetic resonance imaging (MRI). FTD leads to loss of brain tissue that is visible on MRI scans of living people.
Iona K Lister - Based in the United Kingdom, I have written four published books and hundreds of articles. Subjects cover a wide range – including ...
