People living with dementia are sometimes said to have “no filter,” which can make caregiving extremely challenging.
Of the many different forms of dementia, frontotemporal dementia (FTD) is known for causing severe changes in mood and personality. This can create frustration and even embarrassment for caregivers who are trying their best to provide care for loved ones.
Also known as Pick’s Disease, frontotemporal dementia is distinguished by increasingly unusual or inappropriate behaviors that can raise serious concerns for family members.
In this article, we’ll explain how frontotemporal dementia is different from other dementias and offer helpful tips on when to seek professional memory care support for your loved one.
What is frontotemporal dementia?
Unlike Alzheimer’s disease, which is a specific condition, there are over 400 different types of dementia. One of the rarer types is known as “frontotemporal dementia.”
It also goes by the names Pick’s Disease, frontal lobe dementia, semantic dementia, and FTD.
Frontotemporal dementia affects the brain’s frontal and temporal lobes negatively by impacting accumulations of proteins. It blocks the brain’s ability to use neurons to communicate with the nervous system.
Because the frontal and temporal lobes are the executive centers of the brain, it results in unusual or radical behavioral symptoms when impaired, making your loved one act out in uncharacteristic ways.
It can be easy to misdiagnose frontotemporal lobe dementia as Alzheimer’s, as they have many overlapping symptoms.
However, the most prominent symptom of frontotemporal dementia is an extreme shift in behavior and dysfunction of language. Your loved one could say or do things they normally would never do.
Compared to Alzheimer’s, which has an average onset of 65 years, people with frontotemporal dementia usually develop the disorder around the age of 45.
Of all the forms of dementia, frontotemporal dementia makes up around 10% to 20% of all dementia cases, making this a rarer form of dementia.
What are the different variations of frontotemporal dementia?
There are two main variations of frontotemporal dementia — behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA).
These conditions can negatively impact a person’s social and personal behavior and their ability to communicate using language.
Behavior variant frontotemporal dementia (bvFTD)
The behavior variant of frontotemporal dementia is characterized by inappropriate behaviors, including a lack of inhibitions, making sexually inappropriate comments, apathy, aggression, and a lack of empathy.
Because the frontal lobe is the executive center of the brain, when this lobe is damaged it will result in uncharacteristic behaviors that negatively impact judgment, and manners, making your loved one act and speak without any filters or inhibitions.
Primary progressive aphasia (PPA)
The use of language in the brain is also negatively impacted, resulting in the inability to recognize or find the right words to use when speaking.
One subvariant of aphasia, semantic dementia, creates a condition known as “word deafness” which causes a person to lose the ability to recognize certain sounds as words, impacting their ability to understand speech.
Another subvariant called nonfluent variant primary aphasia blocks a person’s ability to speak or find the right words to use, creating choppy, ungrammatical sentences that may not make sense.
How is frontotemporal dementia diagnosed?
Like most forms of dementia, there isn’t a single test that can accurately diagnose frontotemporal dementia. Diagnosis will depend on multiple assessments made by your loved one’s doctor that can include the following.
Brain imaging scans
Brain scans such as CT scans and MRIs are used to rule out other issues that may be causing your loved one’s shift in behaviors.
Strokes and traumatic brain injuries (TBI) can also cause confusion, speaking difficulties, and aggressive or unusual behavior, and brain imaging scans must be used to rule these out as possibilities.
Doctors can use blood tests to check for blood levels of a certain protein called neurofilament light chain (Nfl). This protein is released at higher rates when nerve cells are damaged by frontotemporal dementia (FTD) and other forms of dementia.
Additionally, levels for Nfl can be tested through spinal fluid samples.
A neuropsychologist will perform an evaluation that lasts several hours to test your loved one’s orientation, memory, language, and motor functions.
Additionally, a speech and language pathologist may run an evaluation if they suspect your loved one may be suffering from aphasia or language difficulties.
Because sleep apnea can create similar symptoms such as memory and thinking problems, and unusual behaviors, sleep studies are sometimes performed to rule out sleep apnea as the cause of cognitive decline.
What are the top 5 symptoms of frontotemporal dementia?
The key difference between Alzheimer’s disease and frontotemporal dementia (FTD) is that Alzheimer’s affects the entire brain, whereas FTD only affects the front and temporal lobes.
Because the frontal and temporal lobes regulate a person’s behavior, the main symptoms are usually related to acting out or saying unusual things that can raise serious concerns.
The five most common symptoms of frontotemporal dementia include:
- Unusual or antisocial behavior, such as aggression, rudeness, lack of empathy, impulsive decisions, lack of judgment, or making sexually inappropriate comments or gestures
- Pica, an eating disorder that causes a person to eat or crave inedible objects such as soap or dirt
- Changes in hygiene, such as a lack of bathing or dressing
- Repetitive and compulsive behaviors such as lip smacking, chewing, and making clicking noises with the mouth
- Developing a sweet tooth or eating much more carbohydrates than usual
What are the complications of frontotemporal dementia?
In addition to behavioral changes, frontotemporal dementia also causes muscle rigidity, increasing your loved one’s fall risk, which is the leading cause of most hospital visits.
The most serious complications of FTD, however, are the dangerous and concerning behaviors that become more severe as the disease progresses. These can put your loved one in harm’s way or make them injure themselves due to impulsive decisions or increased aggression and antisocial behavior.
Wandering, arguing, and a lack of understanding of social queues and manners can put your loved one in physical or legal danger if left untreated or unsupervised.
When to seek a memory care community for your loved one
If you’ve begun to notice your loved one’s behavior changing for the worse and are not sure why, take your loved one to a specialist who can diagnose their condition.
Family members and caregivers of people living with FTD may feel embarrassed or personally offended by their loved one’s actions and comments.
Still, it’s important to remember your loved one has a disease that they cannot control that’s making them act inappropriately. It’s not their fault and they cannot help themselves—it’s the disease talking, not them.
As a caregiver, you’ll likely feel frustrated and may experience caregiver fatigue, neglecting your own needs as you spend most of your time taking care of your loved one in their home or your family home.
Eventually, you may want to consider moving your loved one to a memory care community that can provide the 24/7 supervision and support that your loved one’s advanced healthcare needs require.
While there is no cure for frontotemporal dementia, medications, physical rehabilitation, and speech therapy can help reduce your loved one’s symptoms.
It’s always recommended to begin the transition sooner rather than later. Moving your loved one will only get more difficult as their condition progresses. Talk to them early about a potential transition to a care community.
Get dementia and memory care support at The Kensington Reston
If you’re concerned about your loved one with frontotemporal dementia and want more information on our memory care program, please contact us today.Our Promise is to love and care for your family as we do our own.