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Frontotemporal Dementia (FTD)

Any information regarding treatments in this page are provided as a reference only, and are not intended as treatment advice.

Frontotemporal Dementia (FTD) is a relatively rare condition that involves the progressive loss of executive functions (problem-solving, planning, organizing, sequencing, abstracting, social judgment, and motivation) and/or language skills. The causes of FTD are not fully known, though there are probably several distinct disease processes that can lead to this syndrome.

FTD is an early-onset dementia that can start as early as age 35 and usually not after age 75 [ref]. Once it sets in it tends to run a progressive course, worsening over time. The proposed diagnostic criteria include [ref]:

  • The development of behavioral or cognitive deficits manifested by either:
    • Early and progressive change in personality, characterized by difficulty in modulating behavior, often resulting in inappropriate responses or activities, or
    • Early and progressive change in language, characterized by problems in expression of language or severe naming difficulty and problems with word meaning
  • The above symptoms represent a clear decline from one's previous level of functioning and cause an impairment in one's ability to function as usual in social or occupational activities. Furthermore, they are not due to other identifiable neurological, medical, or psychiatric conditions.

The personality changes mentioned above usually involve impulsive and inappropriate behavior, such as losing one's temper in uncharacteristic ways, swearing inappropriately, over-eating, or no longer maintaining one's usual level of social tact and graces. As the condition progresses, the individual can start to mishandle their finances in a serious way, shoplift, go on impulsive buying sprees, or start grabbing food from other people's plates. They may also act in sexually inappropriate ways, or dangerously, such as walking into traffic because something of interest has caught their attention. Compulsive and repetitive behaviors can develop, such as as needing to repeat certain acts repetitively or becoming very stringent about seemingly arbitrary routines. They can lose concern for their appearance and the consequences of their actions and can also become generally apathetic. These symptoms can be easily mistaken for other psychiatric disturbances such as Depression, Bipolar Disorder, or Schizophrenia.

The language disturbances that can occur, as described above, can progress to the point where the person becomes completely unintelligible or mute.

Aside from these cognitive disturbances, other areas of functioning such as memory and learning can remain relatively intact until well into the more advanced stages of the disease. In this respect, FTD differs substantially from Alzheimer's Disease.

Treatments for FTD are sparse. SSRI antidepressants have been shown to help curb some of the impulsiveness and inappropriate behaviors [ref].

 

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Parkinson's and Lewy-Body Dementia

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