Breaking down the news: What is frontotemporal dementia?

Published: Wednesday, February 22, 2023

For many people, the recent announcement that Bruce Willis has frontotemporal dementia came with some sadness—and some confusion. What is this specific type of dementia?

You’re probably familiar with Alzheimer’s disease, which is the most common type of dementia. But dementia is an umbrella term for many different conditions that impact a person’s ability to think, remember or make decisions. In total, there are more than 100 different types of dementia.

While frontotemporal dementia is less common and well-known than Alzheimer’s disease, that doesn’t mean it’s uncommon. It’s actually the most common type of dementia among younger adults. In fact, according to the Alzheimer’s Association, this type of dementia is nearly as common as early-onset Alzheimer’s disease among those between the ages of 45 and 65.

Wondering what happens when a person has frontotemporal dementia? We’re breaking down the facts about this type of dementia below.

Defining frontotemporal dementia

This type of dementia occurs when the brain’s frontal and temporal lobes are damaged, which negatively impacts thinking and behavior. Over time, the damage done to nerve cells in the brain causes the lobes themselves to shrink.

There are two primary types of frontotemporal dementia, which is also sometimes called frontotemporal degeneration:

  • Behavior variant frontotemporal dementia causes a person to experience rapid changes in personality and behavior. With this type of dementia, nerve cell loss most impacts the areas of the brain responsible for judgment, empathy and conduct.
  • Primary progressive aphasia, on the other hand, primarily affects a person’s ability to speak, write, communicate and comprehend. Within this type of dementia, there are two subtypes—semantic, where a person loses the ability to understand or formulate spoken words, and nonfluent/agrammatic, where a person’s speaking is halting and hesitant or ungrammatical.

There’s also a less common variety of frontotemporal dementia that affects movement, causing similar symptoms to conditions like Parkinson’s disease. There are two subtypes of frontotemporal dementia related to motor function—corticobasal syndrome and progressive supranuclear palsy.

Because Willis’ condition was first reported last year as aphasia, he is believed to have a form of primary progressive aphasia, either semantic or nonfluent/agrammatic.

The symptoms of frontotemporal dementia

Because there are different types of frontotemporal dementia affecting specific parts of the frontal or temporal lobes in the brain, symptoms can vary widely. Symptoms may include:

  • Body stiffness
  • Compulsive eating
  • Decreased energy or motivation
  • Decreased self-awareness
  • Difficulty planning or organizing
  • Dramatic behavior or personality changes, like a sudden propensity to swear or steal
  • Hesitancy to speak or when speaking
  • Impaired judgment
  • Inability to focus and increased distractibility
  • Inability to use or understand language
  • Increased agitation
  • Increased clumsiness
  • Lack of empathy
  • Lack of interest in previously enjoyed activities
  • Mood swings
  • Muscle weakness
  • Repetition of words or phrases
  • Shaky hands
  • Social and emotional withdrawal from other people, including loved ones

Someone with primary progressive aphasia may experience the communication-related symptoms outlined above, while someone with the behavioral variant is more likely to experience changes in his or her actions and interactions with others.

Diagnosing & treating frontotemporal dementia

Most types of dementia can be challenging to diagnose, and that’s the case with frontotemporal dementia, since its symptoms often mimic those of other conditions.

To diagnose frontotemporal dementia, a medical provider will conduct a thorough and comprehensive personal and family medical history. During a physical examination, the provider will check neurological status (such as reflexes and muscle strength) and neuropsychological status (like memory and attention span). Additional testing, such as blood work and imaging scans of the brain, may also be ordered to confirm a diagnosis.

Currently, there are no therapies to cure or slow the progression of frontotemporal dementia. Treatment focuses on alleviating symptoms and may include a combination of medications, behavioral therapy and physical, speech and occupational therapy.

These treatment options can help maintain quality of life, even as the condition progresses. Because frontotemporal dementia is a degenerative brain disease, it will worsen over time.

While the condition itself is not fatal, having this type of dementia predisposes a person to life-threatening issues, such as difficulty swallowing and the risk of pneumonia or respiratory failure. Average life expectancy after diagnosis is approximately seven and a half years.

How frontotemporal dementia differs from Alzheimer’s disease

Because most of us are familiar with Alzheimer’s disease, you may wonder how this type of dementia is different from Alzheimer’s. There are a few key differences.

The first difference is the part of the brain affected by the dementia. Alzheimer’s disease affects the entire brain, while frontotemporal dementia impacts the frontal and temporal lobes specifically.

Those who are diagnosed with frontotemporal dementia are typically younger than those who are diagnosed with Alzheimer’s disease. While early-onset Alzheimer’s is possible, the condition is most common among those age 65 and older, while frontotemporal dementia is most common among those between ages 45 and 65.

The symptoms of the two types of dementia also differ. When you think about Alzheimer’s disease, memory loss is probably the first symptom to come to mind. While memory loss does occur in those who have frontotemporal dementia, particularly in the end stages of life, it is a less prominent symptom.

Learn More

Northeast Georgia Physicians Group Neurology treats a wide range of neurological conditions, including dementia. Call 770-219-6520 or click here for more information.