Symptoms of Frontotemporal Dementia (FTD)

For someone diagnosed with frontotemporal dementia (FTD), it can cause great uncertainty and anxiety for them and their loved ones. 

There are many questions that arise and need answers as soon as possible—especially when it comes to the causes and possible symptoms of FTD that might be in store for them.

Kensington Park Senior Living’s team of dedicated staff members has created a tight-knit community of medical professionals and caregivers that adhere to their Promise to care for your loved ones as you would.

Furthermore, along with providing our guests with the needs of daily living (like proper nutrition), we strive to provide our guests’ families with some answers regarding a diagnosis of FTD.

Just like when we all rose to the challenges of COVID, understanding your loved one’s disease and symptoms can help alleviate some of the stresses of this challenging situation.

Let’s look at the various possible symptoms of frontotemporal dementia and its causes.

What is frontotemporal dementia?

Frontotemporal dementia (also called frontotemporal lobar degeneration) is a term that refers to a group of diseases. The common characteristic of each involves the deterioration of the frontal and temporal lobes of the brain.

As these different frontotemporal disorders progress, the person loses their ability to control their behavior in many ways. Speaking and understanding spoken languages frequently become compromised, depending on the affected area of the brain.

Those afflicted with FTD fall under one of three common symptom groups. Two of these groups are subtypes of primary progressive aphasia (PPA). Despite the similarity in names, this form of dementia is actually quite different from aphasia symptoms that sometimes accompany a stroke.

The three common groups are:

1. bvFTD or Behavioral-variant frontotemporal dementia
2. svPPA or Semantic-variant primary progressive aphasia (semantic dementia)
3. nfvPPA or Nonfluent/agrammatic PPA

Also, FTD can sometimes “cluster” with other conditions. For example:

• FTD-ALS. Frontotemporal dementia is noted along with amyotrophic lateral sclerosis (ALS).
• Parkinson’s disease-like syndromes can appear with FTD, including corticobasal degeneration and progressive supranuclear palsy (PSP).

Diagnosis of FTD

There is no direct test for any type of FTD. 

Typically, a health care provider specializing in neurology can diagnose FTD based on medical history, family history, and an examination (both physical and cognitive).

During the examination, the doctor will look for signs and symptoms of the disease. Blood tests can help eliminate other possible diseases that have similar symptoms. A magnetic resonance imaging scan (MRI) might show areas of the brain that are deteriorating.

The symptoms of frontotemporal dementia

The symptoms of FTD will depend on which parts of the brain are being affected by the disease. 

FTD affects everyone differently because no two brains are alike. There are many similarities in symptoms, but they frequently appear in different combinations and severity.

In regards to bvFTD, there are seven categories of symptoms:

1. Losing inhibitions
2. Disinterest in life—this new apathy is sometimes misdiagnosed as depression
3. Lack of empathy
4. Compulsive behaviors
5. Diet changes, such as an increase in eating carbohydrates or sweets
6. Odd mouth-centered behaviors
7. A decline in executive function and cognition—the ability to organize thoughts and activities, prioritize and manage time efficiently, and decision-making skills.

Let’s break down these symptoms a little more to clarify things.

Losing inhibitions

When your brain is telling you not to do something, that your impulse is inappropriate for the situation, it is inhibiting that impulse. 

Frontal lobe deterioration of the brain cells interrupts that stopgap system and may look like the following:

• The person loses their “filter.” They might say offensive, hurtful, or rude things. This development might be a major personality shift for them.
• Lack of personal respect. Perhaps the person gets far too close when talking to others (ignoring personal space etiquette). Inappropriate sexual actions or comments are also common.
• Impulsive behaviors or actions. Sometimes, these impulses can involve risk, like sudden spending, gambling, or petty theft (shoplifting).

Apathy

Health care providers and caregivers may mistake apathy for depression because they appear very similar. People suffering from apathy tend to have symptoms like:

• A loss of motivation.
• They become more socially isolated.
• There is a decline in personal hygiene.

Lack of empathy

Sometimes called “emotional blunting,” people who lose their sense of empathy may have difficulty reading others’ emotions. As a result, they may start behaving in an unfeeling, uncaring, or “cold” manner.

Compulsive behaviors

The early stages of FTD might show as small and limited behavioral changes. However, in other cases, the degeneration of nerve cells can cause dramatic changes similar to motor neuron disease.

Some examples include:

• Repetitive motions—often repeating subtle, small-scale movements like clapping hands, pacing or tapping their feet.
• Ritual-like behaviors—compulsively re-watching the same film or reading the same book. Hoarding is also a symptom.
• Repeating speech—someone afflicted with FTD might repeat the same words, sounds, or phrases.

Mouth-centered behavioral changes

A common symptom of FTD is that patients will have “hyperorality,” meaning they will overeat or eat things that aren’t considered food (also known as pica).

Some will develop mouth-centered compulsive behaviors like smacking their lips or exploring things with their mouths in the usual way babies behave.

Loss of executive function

The cognitive ability for problem-solving, planning, staying organized, and motivation is part of our “executive function.” People with FTD have difficulty with executive function; however, unlike other types of dementia like Alzheimer’s disease, there is no associated memory loss until they reach the later stages of the FTD.

Primary progressive aphasia symptoms

Of the three main subtypes of PPA, there are two that can occur with FTD:

• nfvPPA or Nonfluent variant PPA involves language problems and language skills. Simple sentences and individual words are understandable, but more complicated sentences become confused.
• svPPA or Semantic variant primary progressive aphasia involves difficulties with the choosing and understanding of words.

The benefits of memory care communities

As people grow older, it is common to need assistance at some point. 

If you are struggling with the responsibilities of caregiving for your loved one with FTD or any type of dementia, it might be a sign that it is time for a change.

Beyond the needs of assisted living or senior living facilities (like rehabilitation services or alternative therapies), loved ones who are dealing with challenges like FTD or Alzheimer’s disease frequently need more acute care than what can be found at home.

Kensington Park’s memory care has the resources and experience to care for your loved ones as you do. 

Reach out to one of our dedicated staff members to check out your options.