Frontotemporal Dementia: What is it and how to cope?

Although Alzheimer’s disease may be credited as the most notorious memory loss disorder, it is certainly not the only dementing disease. There are many other types of dementia — upwards of 50 different types. Depending on the type of dementia, the disease may have different symptoms, trajectories, or treatment options. Frontotemporal dementia is one non-AD type of dementia.

What is it?

Frontotemporal dementia (FTD) accounts for approximately 15% of cases of dementia. It is characterized by degeneration in the frontal (executive functions) and temporal lobes (memory, language, emotions) of the brain.  In Alzheimer’s the person may have stark cognitive deficits early on in the disease (e.g. short term memory problems, word finding difficulties), but the person with FTD may have more obvious behavioral symptoms  in the early stages (such as spending copious amounts of money, eating without restraint, apathy, disinhibition, etc.). FTD also typically affects individuals at a younger age than those who are diagnosed with Alzheimer’s. Most people are diagnosed in their 50s or 60s.

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FTD can be grouped into three different types

  • Behavioral variant frontotemporal dementia (bvFTD) takes its greatest toll on personality and behavior. It may begin with subtle changes that may be mistaken for depression. As bvFTD progresses people often develop disinhibition, a striking loss of restraint in personal relations and social life.
  • Primary progressive aphasia (PPA) affects language skills in early stages, but often also affects behavior as it advances. The two chief forms of PPA have somewhat different symptoms:
    • In semantic dementia, people speak easily, but their words convey less and less meaning. They tend to use broad general terms, such as “animal” when they mean “cat.” Language comprehension also declines.
    • In progressive nonfluent aphasia, people lose their ability to generate words easily, and their speech becomes halting, “tongue-tied” and ungrammatical. Ability to read and write also may be impaired.
  • FTD movement disorders affect certain involuntary, automatic muscle functions. These disorders also may impair language and behavior. The two primary FTD movement disorders are:
    • Corticobasal degeneration (CBD), which causes shakiness, lack of coordination, and muscle rigidity and spasms.
    • Progressive supranuclear palsy (PSP), which causes walking and balance problems, frequent falls and muscle stiffness, especially in the neck and upper body. It also affects eye movements.

How to cope?

As with other types of dementia, managing the behavioral changes that occur with the disease is a daunting task for any caregiver, potentially leading to burnout and distress.  Furthermore, research indicates that FTD caregivers may experience a greater financial, emotional, and psychological burden than their AD caregiver counterparts. Because of the extreme toll that caregiving can pose, the caregiver must take good care of themselves! Support groups and/or therapy may be very helpful outlets. Taking time out and enjoying free time as a caregiver is not frivolous but an essential component in preserving the caregiver’s mental and physical well-being.

Managing behaviors is a common issue when the diagnosis is FTD. Validating the person’s feelings and reality, taking time out for one’s self, implementing a regular routine, and consulting with a physician are all viable methods for tackling this issue.

Research continues to emerge which indicates that physical activity may help to stimulate learning and memory and effectively manage some of the symptoms associated with dementia (Ahlskog et al., 2011). Engaging the person in activities, particularly physical exercise, may be another helpful intervention for managing behaviors.

References

Ahlskog, J. E., Geda, Yonas E,M.D., M.S.C., Graff-Radford, N., & Petersen, Ronald C,P.H.D., M.D. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings, 86(9), 876-84. Retrieved from http://search.proquest.com/docview/886577831?accountid=27927

Rabinovici, G. L. (2010). Frontotemporal Lobar Degeneration. CNS Drugs24(5), 375-398.

Seltman, R. R. (2012). Frontotemporal Lobar Degeneration: Epidemiology, Pathology, Diagnosis and Management. CNS Drugs26(10), 841-870. http://www.theaftd.org

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  1. […] Frontotemporal Dementia: What is it and how to cope? (caregivertwopointoh.wordpress.com) […]

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