The term ‘frontotemporal dementia’ covers a range of conditions, including Pick’s disease, frontal lobe degeneration and dementia associated with motor neurone disease.
Frontaltemporal dementia is an uncommon brain disorder characterised by personality change, and disordered thinking. Frontotemporal Dimentia selectively affects the frontal lobe of the brain and may extend backward to the temporal lobe.
Frontotemporal Dementia Frontal may lead to apathy or conversely disinhibition, disordered high level thinking, perseveration, and personality change. The manifestation will depend on which part of the lobe is more affected dorsolateral or orbitomedial. Many routine dementia assessments do not test the frontal lobe.
All are caused by damage to the frontal lobe and/or the temporal parts of the brain. These areas are responsible for our behaviour, emotional responses and language skills.
Frontotemporal dementia is a rare form of dementia, occurring far less frequently than Alzheimer’s disease, for example. Younger people, specifically those under the age of 65, are more likely to be affected. Men and women are equally likely to develop the condition.
Damage to the frontal and temporal lobe areas of the brain causes a variety of different symptoms. Each person will experience the condition in his or her own individual way.
Personality and behaviour changeTypically, during the initial stages of fronto-temporal dementia, memory is still intact, but the personality and behaviour of the person changes.
People with frontotemporal dementia may:
It is important to recognise that these symptoms have a physical cause, and cannot usually be controlled or contained by the person.
The person with fronto-temporal dementia may experience language problems, including:
The person may overeat and/or develop a liking for sweet foods.
The rate of progression of frontotemporal dementia varies enormously, ranging from less than two years to over ten years.
In the later stages, the damage to the brain is usually more generalised, and symptoms usually appear to be similar to those of Alzheimer’s. People affected may no longer recognise friends and family and may need nursing care.
Frontotemporal dementia is commonly misdiagnosed as Alzheimer’s disease. A specialist may be able to make a diagnosis of fronto-temporal dementia by questioning the person affected and taking a detailed history of their symptoms. They may also ask for information from family, friends and carers, to gain a wider picture of the person’s behaviour.
CT (computerised axial tomography) and MRI (magnetic resonance imaging) scans may also be used to determine the extent of damage to the brain.
A firm diagnosis may only be possible after death, when changes in the structure of the brain can be directly observed at post mortem.
There is a family history in about half of all cases of frontotemporal dementia. In these families the course of the disease usually has a specific pattern across the generations. Some of these inherited forms have been linked to abnormalities on chromosomes 3 and 17.
The causes of non-inherited frontotemporal dementia are so far unknown.
As yet, there is no cure for frontotemporal dementia and the progression of the condition cannot be slowed.
Drugs that are designed for the treatment of Alzheimer’s disease, such as Aricept, Exelon and Reminyl, may make symptoms worse and increase aggression.
However, much can be done to ease symptoms. Knowing more about the disease and understanding why the person is behaving in certain ways can help the person to cope with the disease. Carers may be able to develop coping strategies, such as avoiding confrontation and working round obsessions, rather than trying to change the behaviour of those affected.
Speech therapists may be helpful for language problems.