Understanding Frontotemporal Dementia (FTD)

Frontotemporal dementia (FTD) is one of the rarer forms of dementia but its impact can be particularly devastating. High-profile cases, like Bruce Willis, shine a brighter spotlight on FTD and more people are becoming familiar with it. This post will dive into the different types of FTD, their symptoms, and the ways families can get support.

What is Frontotemporal Dementia?

FTD is an umbrella term for several brain disorders caused by the breakdown of the frontal and temporal lobes of the brain.

There are multiple variants of FTD, each affecting different parts of the brain with unique symptoms. 

Types of Frontotemporal Dementia

Language Variant Frontotemporal Dementia

Language variant FTD affects the language centers of the brain. There are several different variants, such as logopenic-, semantic-, and agrammatic-variant and each of them impacts  language in unique ways. Some possible changes include:

  • Word-Finding Issues: People might struggle to find common words they previously knew. This can lead to saying the wrong word, either a similar-sounding one (e.g., “fen” instead of “pen”) or a related word (e.g., “pencil” instead of “pen”).
  • Language Comprehension: Difficulty understanding what others are saying or issues with reading and writing.
  • Motor Speech Apraxia: Challenges coordinating the muscles in the mouth, jaw, and tongue. Speech can become difficult, short, and with odd breathing patterns to force words out.

In contrast to Alzheimer’s disease, Language variant FTD affects language skills in the early stages and doesn’t significantly impact memory until later in the disease process.

Behavioral Variant FTD

Behavioral variant FTD involves significant changes in personality and behavior:

  • Loss of Empathy and Sympathy: Someone with Behavior variant FTD may no longer be as compassionate or empathetic as they used to be. For example, they might be indifferent to a grieving loved one.
  • Inappropriate Social Behavior: Saying or doing inappropriate things in social settings, including sexual promiscuity or making inappropriate social jokes that are out of character for the person.
  • Poor Decision-Making: Making impulsive and damaging decisions, such as selling a family business without proper consultation or making large, unnecessary purchases without thinking through the consequences.

These behavioral changes can cause significant tension within families. The person with FTD often believes they are behaving normally, leading to conflicts with more aware family members.

Associated Physical Symptoms of Frontotemporal Dementia

FTD can also lead to physical symptoms regulated by the front part of the brain. These can include:

  • Hyperorality/dysphagia: Putting non-food objects in the mouth or holding food/liquid in the mouth without swallowing.
  • Incontinence: Problems with bladder control caused by incorrect signals from the brain, instead of due to problems with the bladder muscles.
  • Perseverative behavior: Sometimes people living with FTD will get stuck in thought or behavior ‘loops.’ For instance, they might develop repetitive or compulsive behaviors that can become highly rigid patterns. Or, they might say the same things over and over – which is separate from a memory problem, as they recall the information, but they are stuck in a repetition loop.   

The Importance of Support and Early Diagnosis of Frontotemporal Dementia

Given the complicated nature of FTD, it’s important for patients and their families to seek early diagnosis and management. This often requires a team of specialists:

Speech and Language Therapy

Especially for those with language variant FTD to help them develop alternative communication methods. This reduces frustration and increases independence.

Psychiatric and Counseling Support 

This is necessary for managing behavioral variant FTD. Family members may also need counseling to cope with the emotional weight and to understand the disease better.

Support groups specifically targeting FTD can provide emotional support and practical advice. These groups can help manage the daily challenges of the disease. Education and specific support group options are available through the Association for Frontotemporal Degeneration

Impact on Younger Individuals

FTD often strikes younger individuals, sometimes as early as their 40s or 50s. This means patients often have children still at home, who also need support. Family counseling can help the entire family navigate this extremely difficult situation. It’s important to help children understand what is happening to their parent and how to not take the changes personally.

If you or a loved one is concerned about frontotemporal dementia, contact Idaho Neuropsychology. We provide expert guidance and compassionate support to help you navigate this challenging condition.