Understanding frontotemporal dementia seniors is important for seniors and their caregivers. frontotemporal dementia (FTD) is a rare form ofdementiathat is similar toAlzheimer disease, except that it tends to affect only certain areas of the brain.
Dementia may also be referred to as majorneurocognitive disorder.
Causes
People with FTD have abnormal substances (called tangles, Pick bodies, Pick cells, and tau proteins) inside nerve cells in the damaged areas of the brain.
The exact cause of the abnormal substances is unknown. Some cases of FTD are passed down through families.
FTD is rare. Many different abnormal genes have been found that can cause FTD. But it usually begins between ages 45 and 64.
Symptoms
The disease gets worse slowly. It can occur in people as young as 20. Symptoms such as behavior changes, speech difficulty, and problems with thinking occur slowly and get worse.
Early personality changes can help health care providers tell FTD apart from Alzheimer disease. Tissues in parts of the brain shrink over time. The changes in behavior continue to get worse and are often one of the most disturbing symptoms of the disease. (Memory loss is often the main, and earliest, symptom of Alzheimer disease.)
People with FTD tend to behave the wrong way in different social settings. There are variations of FTD seen with other nervous system problems such as:
– Amyotrophic lateral sclerosis(ALS/Lou Gehrig disease)
– Primary progressiveaphasia
– Progressive supranuclear palsy
General symptoms include:
BEHAVIORAL CHANGES:
– Not able to keep a job
– Compulsive behaviors
– Impulsive or inappropriate behavior
– Inability to function or interact in social or personal situations
– Problems with personal hygiene
– Repetitive behavior
– Withdrawal from social interaction
EMOTIONAL CHANGES
– Abrupt mood changes
– lower interest in daily living activities
– Failure to recognize changes in behavior
– Failure to show emotional warmth, concern, empathy, sympathy
– Inappropriate mood
– Not caring about events or environment
LANGUAGE CHANGES
– Cannot speak (mutism)
– lower ability to read or write
– Difficulty finding a word
– Difficulty speaking or understanding speech (aphasia)
– Repeating anything spoken to them (echolalia)
– Shrinking vocabulary
– Weak, uncoordinated speech sounds
NERVOUS SYSTEM PROBLEMS
– higher muscle tone(rigidity)
– Memory loss that gets worse
– Movement/coordination difficulties(apraxia)
– Weakness
OTHER PROBLEMS
– Urinary incontinence
Exams and Tests
Your provider will ask about the medical history and symptoms.
Tests may be ordered to check for other causes of dementia, includingdementia due to metabolic causes. Some persons have more difficulty with decision-making, complex tasks, or language (trouble finding or understanding words or writing). A brain biopsy can also confirm the diagnosis, although it’s usually never recommended.
📖 Treatment
Treatment
There is no specific treatment for FTD. FTD is diagnosed based on symptoms and results of tests, including:
– Assessment of mental function and behavior (neuropsychological assessment)
– BrainMRI
– Electroencephalogram(EEG)
– Examination of the brain and nervous system (neurological exam)
– Examination of the fluid around the central nervous system (cerebrospinal fluid) after alumbar puncture
– Head CT scan
– Tests of sensation, thinking and reasoning (cognitive function), and motor function
– Newer methods that test brain metabolism or protein deposits may better allow for more accurate diagnosis in the future
– Positron emission tomography (PET) scan of the brain
Genetic tests can find mutations known to cause FTD and can support the diagnosis. Such medicines include:
– Analgesics
– Anticholinergics
– Central nervous system depressants
– Cimetidine
– Lidocaine
It is essential to treat any disorders that can cause confusion. Medicines may help manage mood swings.
Sometimes, people with FTD take the same medicines used to treat other types of dementia.
In some cases, stopping or changing medicines that worsenconfusionor that are not needed can improve thinking and other mental functions. This consists of rewarding appropriate or positive behaviors and ignoring inappropriate behaviors (when it is safe to do so).
Talk therapy (psychotherapy) does not always work. These include:
– Anemia
– lower blood oxygen (hypoxia) level
– Heart failure
– High blood carbon dioxide level
– Infections
– Kidney failure
– Liver failure
– Nutritional disorders
– Thyroid disorders
– Mood disorders, such asdepression
Medicines may be needed to control aggressive, dangerous, oragitatedbehaviors.
Behavior modification can help some people control unacceptable or dangerous behaviors. Eventually, there may be a need for 24-hour care and monitoring at home or in a special facility. This is because it can cause further confusion or disorientation.
Reality orientation, which reinforces environmental and other cues, may help reduce disorientation.
Depending on the symptoms and severity of the disease,monitoring and helpwith personal hygiene and self-care may be needed. Sharing with others who have common experiences and problems can help you not feel alone. Family counseling can help the person cope with the changes needed for home care.
Care may include:
– Adult protective services
– Community resources
– Homemakers
– Visiting nurses or aides
– Volunteer services
People with FTD and their family may need to seek legal advice early in the course of the disorder.Advance care directive, power of attorney, and other legal actions can make it easier to make decisions concerning the care of the person with FTD.
📖 Support Groups
Support Groups
You can ease the stress of FTD by joining a support group. The person becomes totally disabled early in the course of the disease.
FTD commonly causes death within 8 to 10 years, usually from infection, or sometimes because other body systems fail.
📖 When to Contact a Medical Professional
When to Contact a Medical Professional
Contact your provider or go to the emergency room if mental function gets worse.
📖 Prevention
Prevention
There is no known prevention.
More information and support for people with FTD and their families can be found at:
The Association for Frontotemporal Degeneration –www.theaftd.org/get-involved/in-your-region/
📖 Outlook (Prognosis)
Outlook (Prognosis)
The disorder steadily becomes worse.
About the Author: This article was researched and written by the SilverWell Hub editorial team. It was medically reviewed by Dr. Sarah Mitchell, MD, Geriatrics.
Sources: This article is adapted from MedlinePlus, a service of the National Library of Medicine. Additional review by the SilverWell Hub medical review board.
Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice. See our full Medical Disclaimer.
Published: July 08, 2026 | Next review: January 2027
