Most people are familiar with the term dementia, but few of us know about a specific condition called frontotemporal dementia. It is one of 10 categories of dementia and is often misdiagnosed as Alzheimer’s disease or a psychiatric problem. (See box, “Differences Between FTD and Alzheimer’s,” page 6.)
Frontotemporal dementia (FTD) itself is not a single disease. It is collection of disorders that affects (shrinks) the frontal and temporal lobes of the brain. Brain cell function in those areas is diminished or totally lost because of nerve cell damage. The presence of abnormal proteins may be related to the development of FTD. The result is change in temperament, judgment, conduct, physical function, and speech, according to the International Review of Psychiatry.
The Alzheimer’s Association reports that FTD often develops during a person’s 50s or 60s, although it can happen as early as the 20s and as late as the 80s.
Symptoms. The University of California, San Francisco, Memory and Aging Center says that patients with FTD typically see a physician because of symptoms that fall into one of the three categories below. All three changes happen gradually, although the pace of change varies from person to person.
- Changes in behavior: disregard for social conventions, apathy, impulsivity, loss of ability to sympathize or empathize, repetitive/compulsive movements, dietary changes, decline in personal hygiene, and poor insight, foresight, or assessment.
- Changes in language: problems expressing oneself, difficulty reading and writing, while memory stays relatively intact. This variant of FTD normally occurs before the age of 65, but can develop later in life.
- Weakness or slowing of movement: muscle weakness, poor coordination, difficulty in moving, muscle spasms, difficulty in swallowing, slowing of eye movements and reflexes, muscle stiffness.
How Many People Are Affected? No accurate estimates are available, but there may be between 50,000 and 60,000 people in the U.S. with some form of FTD, most of whom are between the ages of 45 and 65.
It is possible for people to have more than one type of dementia. FTD is the most common cause of dementia in people under the age of 60.
Genetics are a factor. The risk of FTD is higher if someone in your family has had dementia, but not everyone with a family history develops the condition.
Diagnosis Is Difficult. No test is available to diagnose FTD, so doctors try to identify symptoms associated with the various sub-types and to rule out other conditions.
Blood tests can detect liver or kidney diseases. Brain scans using magnetic resonance imaging and positron emission tomography give radiologists detailed images of the brain in order to identify blood clots, tumors, or bleeding.
Neurological and psychological testing is used to assess judgment and memory.
Goal of Treatment Is Management. All forms of FTD eventually lead a person to depend on others for help getting through normal daily activities.
There is no way to prevent FTD or to reverse the symptoms it causes. However, medications such as antidepressants and antipsychotics may reduce behavioral problems.
Cardiovascular exercise is thought to help mood and mental skills. It is important for the person to live in a calm environment, have structured routines, and simplify daily tasks, according to the Mayo Clinic.
Help is available from the Association for Frontotemporal Degeneration
(www.theaftd.org), the Alzheimer’s Association (www.alz.org), and the United States Social Security Administration. Certain individuals may qualify for a compensation allowance or Social Security disability. Go to www.ssa.gov, then choose “Disabilities,” followed by “Compensation Allowances.” Take some comfort in the fact that help is available.
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