Frontotemporal Dementia

What Is Frontotemporal Dementia?

Frontotemporal dementia (FTD) is a type of dementia that happens because of damage to the frontal and temporal lobes of your brain.

You’ve probably heard of Alzheimer's disease. It may be the most common kind of dementia. But there are other types that are less well-known.

FTD is one of them. It tends to affect people between the ages of 45 and 60. That’s earlier than Alzheimer’s shows up. In fact, it’s one of the most common causes of early dementia. Adults who get it are more often still working, having children, and providing for a family.


Dementia is a serious loss of thinking abilities. It causes problems with daily activities like working, driving, and cooking. Frontotemporal dementia affects the parts of the brain that control social skills, decision-making, and judgment.

Doctors use several different names for FTD, including:

  • Pick’s disease
  • Frontal dementia
  • Frontotemporal lobar degeneration
  • Behavioral variant frontotemporal dementia
  • Primary progressive aphasia
  • Semantic dementia
  • Progressive nonfluent aphasia

It’s different from Alzheimer's. If you have it, you won’t lose your memory at first. But you might act differently or do strange things. You may find it hard to focus or get motivated. Your personality might change. Over time, you could find it hard to walk, talk, plan activities, work, and take care of yourself.

But when you know what to expect, that can help you and your family prepare for the changes to come.

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Frontotemporal Dementia Symptoms

It’s hard to say which ones you’ll have first. It depends on where the damage in your brain starts. If it strikes the part that controls decision-making, you might first have trouble managing your money. It could start in the part of your brain that connects your emotions to objects. If it does, you might not recognize that something is dangerous.

The most common types of FTD are:

  • Frontal variant, which affects your behavior and personality
  • Progressive nonfluent primary progressive aphasia, which affects the way you speak
  • Semantic variant primary progressive aphasia, which affects the way use or understand language

Your family may notice you’re acting strange before you do.

Other possible symptoms of FTD include:

  • Emotional problems
  • Loss of interest in things
  • Withdrawing from others

These tend to get worse over time as FTD affects more parts of your brain.

Frontotemporal Dementia Causes and Risk Factors

Scientists don’t know for sure what causes FTD. But it starts when nerve cells in two parts, or “lobes,” of the brain -- the front and the side -- die. That causes the lobes to shrink.

Doctors believe FTD may be genetic. About 4 out of 10 people who have it also have a relative who had it or some other form of dementia.

Genetic FTD happens when you have a mutation, or change, in one of three genes:

  • C9ORF72
  • The protein tau (MAPT)
  • The protein progranulin (GRN)

The type of mutation you have affects the type of symptoms you have.

Frontotemporal Dementia Diagnosis

It can be hard to figure out if someone has FTD. That’s because it often mirrors other disorders, like Parkinson's, Alzheimer's, depression, and schizophrenia.

See a doctor about any strange behavior. They’ll ask about medications and family history. They may also do blood tests to rule out other medical problems. Your doctor might refer you to a neurologist, who will check things like your balance, reflexes, memory, and thinking.

And they may order one or more of these tests:

  • EEG (electroencephalogram). This measures the electrical activity in your brain.
  • CT scan (computed tomography scan). It shows a detailed image of your brain, made with X-rays.
  • MRI. This uses magnets and radio waves to create images of your brain.
  • PET scan. It shows how your brain is working.
  • Spinal tap. This samples fluid around your brain and spinal cord.

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Frontotemporal Dementia Treatment

FTD doesn’t have a cure or treatment. Drugs that slow down Alzheimer’s disease don’t have the same effect on FTD, and may actually make symptoms worse.

The doctor can help you manage your symptoms with certain medications and therapies, including:

  • Antidepressants to help with behavioral issues
  • Antipsychotics to help with behavioral issues, but they may cause serious side effects, such as a higher risk of death
  • Speech therapy to help with communication problems

Living With Frontotemporal Dementia

This condition isn’t life-threatening. But you should find a doctor who knows how to manage it as soon as possible. Speech experts, physical therapists, and nurses may be able to help, too.

You should also think about doing these things:

  • Ask your doctor whether medications can help.
  • Find a support group.
  • Share information with family and friends.
  • Get a driving evaluation.
  • Exercise and eat healthy foods.
  • Create a plan for when your ability to live on your own and make decisions is impaired.

If you’re caring for someone with FTD, you can:

  • Explain to others what to expect when they’re with your loved one.
  • Connect with other caregivers through caregiver support groups.
  • Find respite caregivers who can step in when you need a break.
  • Take care of your own physical and mental health by eating well, getting enough sleep, exercising, and spending time doing things you like to do.

Doctors are learning more about this kind of dementia, which may lead to better diagnosis and care.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on July 31, 2020

Sources

SOURCES:

Johns Hopkins Medicine: “Frontotemporal Dementia.”

Cleveland Clinic: “Frontotemporal Dementia.”

Northwestern University Feinberg School of Medicine: “Frontotemporal Dementia.”

National Institute on Aging: “Common Symptoms,” “Frontotemporal Disorders: Information for Patients, Families, and Caregivers.”

Association for Frontotemporal Degeneration: “Disease Overview,” “Evaluation and Diagnosis,” “Fast Facts about Frontotemporal Degeneration.”

University of California, San Francisco: “Frontotemporal Dementia.”

Mayo Clinic: “Frontotemporal dementia.”

National Health Service (U.K.): “Frontotemporal Dementia.”

Journal of Neurology: “An update on genetic frontotemporal dementia.”

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