Frontal Temporal Dementia

Frontal Temporal Dementia

Frontal Temporal Dementia (FTD) is quite different from Alzheimer’s disease as new learning and memory problems are usually not the first symptom or challenge a person will experience. Since the condition predominantly starts with either behavior or language problems, it is frequently mis-diagnosed as a psychiatric condition instead of a dementia related illness.

Signs of Frontal Temporal Dementia

Here are some facts and points about FTD:

  • Progression of FTDs may look very different than other forms of dementia
  • It is possible to have a mixed picture diagnosis that will include a combination of FTD and another dementia.  Most common is FTD plus Alzheimer’s Disease.
  • FTD symptoms will often begin at a much younger age than a typical Alzheimer’s diagnosis (40-55 versus over 70).
  • Some forms of FTD will have characteristics similar to that of Parkinson’s Disease.
  • The use of typical Alzheimer’s medications may have little or no effect, and in some cases may make behaviors worse in the early stages of some FTDs

What Is Frontal Temporal Dementia?

FTDs are a group of neurological conditions that progressively damages brain tissue, starting at the front part (frontal lobe) of the brain.

Early detection and diagnosis combined with the appropriate support and careful use of certain medications can make a difference in well-being.

Who Does Frontal Temporal Dementia Affect?

  • At this time, more men than women diagnosed with FTD.
  • Risk is higher, if there are close blood relatives with FTD, but a clear genetic link has not been identified.

There are multiple forms of this dementia, which will discuss in more detail below.

Frontal Lobe Dementia (FvFTD or FLD)

These individuals will have changes first in their left frontal lobe and may include:

  • Behavior or expressions that are not socially acceptable. For example, a person may sing loudly in a quiet or public space, eat off another person’s plate in a restaurant, urinate on an artificial tree in a mall, or make derogatory or judgmental comments directly to someone.
  • Impulsivity.  Persons living with FTD will take risks and have poor judgment about safety. They may drive fast or risky, shop lift, mis-handle money, use weapons, over-eat, drink excessive alcohol, damage existing relationships, and be over-active sexually or aggressive.
  • Shows dis-inhibition, be overly friendly, or try to be humorous.
  • Inability to begin tasks or activities.
  • Difficulty making decisions.
  • Will become fixated on ideas or actions.
  • Unable to stay focused or complete activities.
  • Not know how to behave in various social situations.
  • Unable to see how their behavior or words affect others.
  • Lack of personal hygiene.
  • Unable to change how a problem is approached or considered.
  • Repeat the same movement or action over and over (pulls hair, taps a finger, claps, smacks lips, etc.)
  • Manipulative actions such as picking up and handling or fidgeting with objects and items they find.
  • Putting things in their mouth or eating excessive amounts of salt, fat, and sugar foods.  It is common for people to experience weight gain due to compulsive eating or drinking.
  • Language may be impulsive but not lost.

Temporal Lobe Dementia

These individuals will present with speaking and comprehension of language problems. Damage is first noted in the left temporal lobe of the brain.

Primary-Progressive Aphasia

Non-Fluent Aphasia symptoms include:

  • Difficulty finding the names of objects
  • Hesitant production of words – slowed speech or stuttering
  • Not speaking or speaking very little
  • Worsening of speech production over time
  • Repetition of words that are heard over and over
  • Saying the wrong words sometimes known as ‘word salad’
  • There may also be problems understanding spoken and written words as well change in speaking ability
  • Non-language skills are often NOT affected at first and the person may be able to perform most other personal activity without difficulty at first

Semantic Dementia

Fluent Aphasia symptoms include:

  • Problems with naming items and with understanding the meaning of words
  • Continued ability to produce the rhythm of speech so it will sound like the person is saying something, but the words will not make sense
  • There may be pauses in speech to find a specific word, otherwise speech is smooth and seems like it should have more content
  • The person may repeat their phrases and ‘important’ words over and over during conversations without being aware of the repeats
  • Facial expressions and gestures may continue to occur during speech

Frontal-Temporal Dementia – (FTD, FTLD, Pick’s Disease)

This condition includes brain change in the frontal and temporal lobes and can include Pick’s bodies found in microscopic inspection of brain tissue after death.  Symptoms can include:

  • Change in impulsivity, dis-inhibition, hyper-orality, decreased attention, perseveration of speech and action, stereotypical actions and words, loss of empathy and social awareness
  • Decreased speech production, struggles with language and comprehension, outbursts of song or inappropriate words or phrases, or echolalia; the uncontrollable and immediate repetition of words spoken by another person
  • Difficulty thinking things through, concentrating on tasks, loss of problem solving
  • As the disease progresses, symptoms worsen and then other problems develop that present more like Alzheimer’s disease.

Contact Orchard at Athens if you have questions about Frontal Temporal Dementia. The clinical team at Athens is specifically trained to support people living with this type of dementia.

Orchard’s “Communities within a Community” Spectrum of Care model includes small neighborhoods that will allow residents to have support and services based on differing acuity’s that reside within an assisted living and memory care setting.

The Cypress Grove (a dementia support and assistance neighborhood) has 17 apartments and was specifically designed to care for someone living with a Rare Dementia such as FTD. The staff’s comprehensive training will include nonjudgmental and empathic approaches to the unique behavioral expressions that most often accompany conditions described.

Additional Resources on Fronto-Temporal Dementias: