Frontotemporal dementia (FTD) is the most prevalent kind of dementia, and Bruce Willis’ family recently made the announcement that the actor has it. FTD happens when nerve cells in the frontal and temporal lobes of the brain die off. Because Mr. Willis, now 67 years old, has been diagnosed with aphasia, he has decided to leave the performing industry. “FTD is a horrible disease that many of us have never heard of and may strike anyone,” the family said in a statement.
Primary progressive aphasia, which causes difficulty communicating, and behavioural variant frontotemporal dementia, which causes behavioural and personality problems, are the two most common forms of FTD. Professor of neurology at the University of California, San Francisco Dr. Bruce Miller said, “It strikes the portions of the brain that make us the most human.”
Susan Dickinson, the head of the Association for Frontotemporal Degeneration, has stated that FTD is the most frequent form of dementia in those under the age of 60. She also noted that around 50,000 persons in the United States have been diagnosed with FTD; however, many experts believe this estimate to be significantly low because of how difficult it is to make a diagnosis. Rather than relying on a single biomarker or blood test, doctors diagnose the illness by looking for specific symptoms and using neuroimaging techniques. Ms. Dickinson has found that it takes patients almost three years, on average, to receive a correct diagnosis.
When does frontotemporal dementia typically begin to show itself?
One sign of primary progressive aphasia is a decreased ability to understand or make normal speech. Reading and writing may be particularly challenging for them.
According to Dr. Ian Grant, an assistant professor of neurology at Northwestern University’s Feinberg School of Medicine, those with the behavioural variety of FTD may exhibit irrational conduct. The patients “seem like they’ve lost a little bit of their filter,” he said, according on feedback from family members. Someone who is usually shy and reserved can suddenly start shouting obscenities or making rude comments about the appearance of a complete stranger. Dr. Miller warns that the individual may become unmotivated and display symptoms of apathy. There is a possibility that some people lack empathy.
FTD patients often can’t do more than one thing at once or make plans, so they waste a lot of time and energy. Dr. Joel Salinas, clinical assistant professor of neurology at NYU Langone Health, explained that frontotemporal dementia can also appear in compulsive gambling and impulsive spending.
Dr. Grant discussed how personality changes associated with FTD can lead to reckless behaviour and bad judgement, such as finishing an entire bottle of maple syrup. It’s possible, he said, that “they’re demanding quick satisfaction, with no real way to put a check on that.”
According to Dr. Grant, these signs can lead to a false diagnosis of a psychiatric ailment like bipolar disorder. Nonetheless, there are a few methods that can be used to tell FTD apart from psychiatric disorders: Those in their 50s and 60s are most at risk for developing frontotemporal dementia, and he noted that it is uncommon, but not impossible, for someone to develop a new psychiatric condition at that age without a preexisting history of mental health difficulties.
Also, a brain scan can show shrinking or atrophy in the frontal lobes of a person with FTD, but this is less likely to be the case in a person with a psychiatric disorder.
Just what are the root causes of frontotemporal dementia?
Dr. Miller added that while genetics play a large role in FTD risk, beyond that, most clinicians do not know what causes the condition. Exercise, social interaction, and maintaining cognitive activities like reading, crossword puzzles, language study, and musical practise have all been shown to reduce the risk of developing dementia and slow the progression of the disease, he said, and these benefits hold true even for those with a family history of the disease. Ms. Dickinson emphasised that there is no proof that a particular activity can protect against FTD.
How does one go about getting FTD treated?
When asked about the average lifespan of FTD patients, Dr. Grant indicated that it is between five and seven years after the onset of symptoms. No treatment exists, but “there’s a distinction between a sickness not having a cure and saying, ‘There’s nothing we can do,'” he said.
Patients with language impairments can benefit from occupational therapy. Dr. Salinas also mentioned that speech therapy can be helpful for these patients.
Care plans for people with FTD are generally developed in collaboration between the patient’s treating physician and the patient’s family or other loved ones, and may include preventative measures to prevent the patient from harming themselves or others. Some patients may be offered antidepressants to assist them deal with mood or behavioural issues, as noted by Dr. Miller, and these medications can be helpful in managing the condition.
Ms. Dickinson noted that stable, routine schedules are beneficial to patients. She also mentioned that support groups are helpful for many patients and their loved ones.
A doctor’s job also includes making sure patients’ families are taking care of themselves. Dr. Miller observed that it is not just the patient that experiences hardship, but also the patient’s loved ones.