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Types of Dementia

Frontotemporal Dementia

Frontotemporal dementia is a type of dementia that tends to occur at a younger age than does Alzheimer's disease . Typically the onset occurs between the ages of 40 and 70.Frontotemporal dementia has less to do with memory loss in the early stages and more to do with changes in personality and behaviour because of the part of the brain that it affects.

Frontotemporal dementia affects the front part of the brain known as the frontal lobes. This is the part of the brain that regulates insight, reasoning and comportment. Comportment is the term used to describe social behaviour, insight and appropriateness in social situations. A person with normal comportment would have the insight to recognize what behaviour is appropriate in a given social situation. The first sign of Frontotemporal dementia (FTD) that the family or caregiver often notices is a gradual change in the person's customary ways of behaving and responding emotionally to others. They may also describe inappropriate or bizarre social behaviour that is very unlike the person.

Often these behaviours fall into two stereotypes: One is the person who is disinhibited - the mild-mannered, polite person who becomes disinhibited and swears, who is rude to the waitress, who becomes loud and garrulous and coarse. Another stereotype is the person who is withdrawn, not motivated, who just sits and who does not do much. This person may even require prompting to look after his/her own personal hygiene. Each presentation reflects an involvement of a part of the frontal lobes. Usually, the picture becomes mixed over time, but the initial presentation can depend on which part of the frontal lobes is affected first. Because of their nature and the age at which they occur, these symptoms are often misdiagnosed as psychiatric disorders such as depression , schizophrenia or bipolar disorder.

Frontal lobe dementias are part of a larger group of disorders called the "focal atrophies", but commonly these spread to involve other parts of the brain. Sometimes the disease features merge with their personality prior to the onset of dementia. An example of this would be aperson who has been somewhat odd throughout their life, yet a very engaging and successful business owner. Over time, as judgment becomes impaired, the business becomes less successful. It can take a while to recognize that a dementia is involved, and not simple business misfortune, or an unlucky call.

Another less common symptom of Frontotemporal dementia would be early and progressive changes in the person's language function. While memory stays intact,many people will present problems with "expressive language" such as finding the correct word or naming objects. The person may also show obsessive, repeating patterns of movement and behaviours like hand-washing, or repeating whatever is said to them. In the late stages, there is often an oral fixation , which can lead to people overeating and to putting objects other than food into the mouth. (Also see Pick's disease ).

The frontal lobe of the brain is the part that governs our mood and behaviour. The person's mood and behaviour may become fixed and difficult to change, making them appear selfish and unfeeling. Relationships can be significantly disrupted due to these behavioural and personality changes. Because of the disease, the spouse/family must take over decision-making that was once shared. The spouse/family is required to make many adaptations in response to the behavioural and personality changes associated with Frontotemporal dementia. Caregiver research has shown that behavioural symptoms are often more stressful for families than cognitive symptoms like memory loss associated with Alzheimer's disease.

Researchers estimate that at least 2 percent of all dementia cases affect the frontotemporallobes. The disease appears to run in families - between 20 percent and 50 percent of people who have Frontotemporal dementia have a family history of some type of dementia. After diagnosis , the course of the disease may run anywhere from two to 10 years before resulting in death.

See Also:
About Dementia > Types of Dementia > Pick's Disease
Symptom Library > Behaviour > Inappropriate Language and Behaviour
Symptom Library > Leisure Activities > Interaction with Friends and Family
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Last updated July 18, 2014
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