Alzheimer's Foundation of America

Foundation of America

What is FTD?

Q&A with Allison B. Reiss, MD, AFA Medical, Scientific and Memory Screening Advisory Board Member

The announcement of actor Bruce Willis’ dementia diagnosis earlier in the year—frontotemporal dementia (FTD)—brought to the surface additional questions about what makes this type of dementia different from Alzheimer’s. We went to our AFA Medical, Scientific and Memory Screening Advisory Board for the answers.

What is frontotemporal dementia?

FTD is actually a group of brain disorders that cause progressive degeneration of nerve cells in the front and on each side (temporal lobes) of the brain. It has a relatively young age of onset, most diagnosed between ages 45 and 64 years.

What are the symptoms?

There are a spectrum of symptoms spanning three categories:

1) Behavioral variant FTD, the most common, is marked by changes in behavior and deterioration of personality. The patient may exhibit apathy, reduced sympathy and empathy, poor judgment, altered food preferences, and repetitive behavior. Memory problems are relatively less prominent. There may be emotional outbursts, poor manners, and excessive familiarity with strangers.

2) Semantic variant primary progressive aphasia, most obvious in the early stages, is difficulty in naming objects. Over time, the patient loses the meaning of words and the ability to remember what a familiar object is or how to use it. There may be substitution of related words or replacement of a word they have lost with “that thing” or “the you know.” Some behavioral problems may be noticed. Speech therapy may help for a time. Use of numbers, colors and shapes can be preserved longer than words. Motor abilities are retained.

3) Non-fluent aphasic variant is halting speech with sound errors. The person is using a lot of effort to speak and their grammar is poor, with impaired comprehension of complex sentences.

What causes FTD?

This is unknown except in some rare inherited cases related to specific gene mutations. More research is needed.

Can it be treated?

There is no cure for FTD, and we cannot slow its progress. Behavior modification techniques, SSRIs and, if necessary, antipsychotic medications can help.

How is it different from aphasia?

Aphasia means difficulty speaking, usually because of damage to specific areas of the brain. It has numerous causes and is not associated only with FTD. Aphasia can be due to a stroke, head trauma or infection. Aphasia does not necessarily lead to inevitable loss of functioning and ability to care for oneself.

How is it different from Alzheimer’s?

Unlike Alzheimer’s disease, FTD usually does not include formation of amyloid plaques. There is an association with abnormal tau protein. FTD tends to occur in younger persons. FTD and Alzheimer’s all end similarly with language and behavior profoundly affected and memory dramatically reduced as well. Twenty-four hour care may be necessary, and, unfortunately, death may occur as a result of infections, such as pneumonia.

Allison B. Reiss, MD, is an associate professor of medicine at
NYU Long Island School of Medicine and head of Inflammatory
Laboratory, Biomedical Research Institute, NYU Langone
Hospital-Long Island.

This article was adapted from a print version which appeared in AFA’s Alzheimer’s TODAY magazine.