What is frontotemporal dementia?

Dementia develops when there is progressive damage to the brain. Frontotemporal dementia is the term used to describe a number of different conditions, in which particular areas of the brain are affected leading to characteristic personality and behavioural changes.

Frontotemporal dementia is also known as Pick’s disease or frontal lobe dementia

The name refers to the parts of the brain that are affected in this form of the condition. The damage happens to the frontal and the temporal lobes. The connections between the lobes are affected, some of the chemical messengers that allow the nerve cells to communicate are lost and the brain cells in these areas die. With time, progressively more nerve cells die so that the brain tissue shrinks. This brain damage leads to signs and symptoms that can differ from those usually seen in Alzheimer’s disease.

Brains and behaviour

The frontal lobes, as the name suggests, are found at the front of the brain behind the forehead. This area controls behaviour, planning, problem solving and emotional control. One particular area also facilitates speech.

There are two temporal lobes, one on each side of the brain. They help with communication, knowing names and the meaning of words. They are also involved in recognising people and objects.

Because a different area of the brain is damaged, people with frontotemporal dementia may present with different symptoms from people with Alzheimer’s, especially in the early stages. Instead of problems with forgetfulness and short-term memory loss, damage to the frontotemporal areas can lead to changes in personality and struggles with speech and language.

Dementia of these parts of the brain can lead to individuals behaving rashly or irresponsibly, this can cause problems with driving, so it is particularly important for people with frontotemporal dementia to inform the DVLA.

There are three types of frontotemporal dementia, with each showing different symptoms especially in the early stages. As with all forms of dementia, the signs can be very subtle at first. With time, there is increasing brain damage and the differences between the types of the disease become less evident. Eventually, the disease will affect the individual’s ability to function and live independently.

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Behavioural variant frontotemporal dementia

People with this type of frontotemporal dementia lack control over their behaviour. Even in the very early stages they may not understand or appreciate what is happening to them, so problems are usually picked by friends, family or work colleagues. Early symptoms include:

  • Loss of inhibitions and behaving in a rude or socially inappropriate way.
  • Apathy and loss of interest in people and things they used to like, without appearing sad.
  • Loss of empathy and becoming selfish, unfeeling and unresponsive to the emotions of others.
  • Compulsive behaviours, obsessive new interests and repetitive use of words and phrases.
  • Deterioration in social skills and poor table manners.
  • Change in appetite. People affected may crave sweet, fatty or fast foods and may eat, drink or smoke too much.
  • Problems with planning, organisation and decision making. These can cause difficulties with work and home lives.

Progressive non-fluent aphasia

People with this form of the disease have gradually increasing language difficulties and problems with speech. Early symptoms include:

  • Hesitant, slow or stuttering speech. They may struggle to get their sentences out or mispronounce words.
  • People affected may develop grammatical errors. Some people speak in a pattern called ‘telegraphic speech’, in which linking words like ‘to’ or ‘but’ or ‘and’ are left out.
  • Problems understanding complex sentences.

Semantic dementia

People with semantic dementia also have language problems. However, unlike aphasia, their speech is fluent but may indicate problems with understanding what objects are and finding the right words, confusion about the meaning of very familiar words, or difficulties finding the right word, so that they may describe objects or use generic terms. Problems recognising familiar people and things.

Early onset frontotemporal dementia

Frontotemporal dementia is one of the types of dementia that can affect younger people. Although it can strike in the elderly, it’s most often diagnosed between forty-five and sixty-five years of age. In fact, The Alzheimer’s Society says that it’s the second or third most common dementia in people under sixty-five and that it affects men and women roughly equally.

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Dr Jane Gilbert
Experienced health writer and TV presenter
Jane has over 20 years’ experience as a health writer and TV presenter. Jane writes on a wide variety of clinical and care topics – from explaining the latest studies and research to unpacking conditions and discussing treatment options. Jane holds a MBBS degree from Imperial College, London and spent seven years working in the NHS.