Complete Care for Complex Conditions
Frontotemporal dementia (FTD) refers to a rare group of cognitive disorders that occur when nerve cells in your brain’s frontal and temporal lobes are damaged. As the nerves in those regions of your brain die, your frontotemporal lobes shrink and atrophy—affecting many of the characteristics that help define who you are like personality, behavior, language, thought process and movement.
The two most common forms of FTD are:
- Behavior variant frontotemporal dementia (bvFTD): nerve cell loss occurs mostly in areas of your brain that affect behavior, judgment, empathy and conduct.
- Primary progressive aphasia (PPA): affects nerve cells in the areas of your brain that affect comprehension and communication skills like language, speaking and writing.
There are three distinctive types of PPA. Each cause different symptoms and are defined by the area of your brain they affect most.
- Semantic variant primary progressive aphasia: reduces or eliminates your comprehension of written and spoken language. You may speak fluently but use words and phrases that don’t make sense. You may not understand what others are saying or remember the meaning of words that you use infrequently.
- Logopenic variant primary progressive aphasia: causes difficulty finding the right words even though you still know what they mean. You may repeat sentences or phrases and pause frequently to mentally search for the words you want to use.
- Nonfluent-agrammatic variant primary progressive aphasia: causes problems speaking and remembering how to form words but you know what words mean. Grammar issues are common. You may have trouble understanding or using complex sentences, pronouns and verb tenses.
Recognizing and evaluating the signs of FTD and its associated disorders requires a high level of expertise and training in the wide range of conditions that can affect your brain’s ability to function. The multidisciplinary team of specialists at Penn State Health Milton S. Hershey Medical Center includes cognitive neurologists and specialists in related fields including physical and occupational therapy and speech language pathology working together to offer real solutions to your health challenges.
We focus on your individual symptoms and health history to diagnose your condition accurately and develop innovative strategies to help you and your loved ones cope with the challenges you face as your disease progresses.
Symptoms and Diagnosis
Frontotemporal Dementia Symptoms
The symptoms of FTD vary according to the type and severity of your illness. The two areas affected most are behavior and language.
Extreme behavioral changes are the most common symptom of FTD, including:
- Inappropriate actions, reactions or behavior
- Compulsive, uncontrolled behaviors
- Poor personal hygiene and self-care
- Apathy and lack of interest in activities or hobbies you once enjoyed
- Withdrawal from social interaction
Language related symptoms may include:
- Inability to read or write
- Shrinking vocabulary
- Difficulty forming words or understanding speech
- Language recall issues
- Trouble naming things correctly
Diagnosing Frontotemporal Dementia
There is not a conclusive test for FTD. The condition can be difficult to accurately diagnose and assess because many of its symptoms overlap and mimic the signs of other cognitive disorders. The experts at Penn State Health Milton S. Hershey Medical Center have the clinical experience, training and technology to accurately evaluate your mental and physical challenges and determine their cause.
Testing typically starts with a thorough physical examination and review of your medical history. Interviews with friends and family may be used to identify symptoms and changes in your behavior that you do not recognize yourself.
Additional testing may include:
- Bloodwork and advanced imaging like MRI or PET: help rule out reversible medical conditions that cause similar symptoms to what you’re experiencing.
- Neuropsychological testing: evaluates your memory skills and judgement and helps define the type of dementia you may have.
- Genetic counseling and testing: may be used if you have a positive family history of early-onset dementia to provide insight into your condition and help refine your diagnosis and treatment options.
Outlook
In its early stages, FTD may respond well to care but, over time, the symptoms worsen dramatically and become increasingly more intrusive on your life. The speed at which the decline happens varies from person to person but typically ranges from two to 10 years. Most people with FTD will eventually require assistance and monitoring at home or in a residential care setting.
There is no known medication or treatment that provides lasting relief from FTD.
Care focuses on symptom management and lifestyle strategies that help preserve your independence and quality of life as long as possible.
Treatment may include:
- Medication: prescription drugs may help alleviate related symptoms like depression and behavior changes like increased aggression or agitation.
- Social work assistance: helps identify and secure needed services that provide care and support for you and your caregivers.
- Personal safety assessment: addresses safety issues like the ability to drive, swallow or live independently as your disease progresses.
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