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Definition of FTD Dementia A degenerative condition of the anterior brain Different from Alzheimer's, Pick's and
Creutzfeldt Jakob's diseases
Definition of FTD Dementia A degenerative condition of anterior brain Different from Alzheimer's, Pick's and
Creutzfeldt Jakob's diseases Areas affected by FTD—the frontal &
anterior temporal lobes—control reasoning, speech, personality, movement, social graces, language and some aspects of memory.
Definition of FTD Dementia A degenerative condition of anterior brain Different from Alzheimer's, Pick's and
Creutzfeldt Jakob's diseases Areas affected by FTD—the frontal &
anterior temporal lobes—control reasoning, speech, personality, movement, social graces, language and some aspects of memory.
Significant impairment in “theory of mind.”
Facts about FTD FTD may account for 2-5% or 140,000 - 350,000
dementia cases & 25% of pre-senile dementias
Facts about FTD
FTD may account for 2-5% or 140,000 - 350,000 dementia cases & 25% of pre-senile dementias
FTD occurs after age 40 and usually before age 65, with equal incidence in men and women.
Facts about FTD FTD may account for 2-5% or 140,000 - 350,000
dementia cases & 25% of pre-senile dementias FTD occurs after age 40 and usually before age
65, with equal incidence in men and women. In half of patients, family hx of dementia exists in
a first degree relative (parent or sibling).
Facts about FTD FTD may account for 2-5% or 140,000 - 350,000
dementia cases & 25% of pre-senile dementias FTD occurs after age 40 and usually before age
65, with equal incidence in men and women. In almost half of FTD patients, family hx of
dementia exists in first degree relative suggesting genetic component.
A form of dementia found in persons with ALS may be associated with FTD.
Major symptoms of FTDEarly Stage
Dramatic change in personal & social conduct with lack of initiative, neglect of domestic, financial and occupational responsibilities.
Major symptoms of FTDEarly Stage
Dramatic change in personal & social conduct with lack of initiative, neglect of domestic, financial and occupational responsibilities.
Loss of empathy toward others (impaired “theory of mind.”)
Major symptoms of FTDEarly Stage
Dramatic change in personal & social conduct with lack of initiative, neglect of domestic, financial and occupational responsibilities.
Loss of empathy toward others (impaired “theory of mind.”)
Shallow affect or inappropriate jocular behavior, sing, dance, clap or recite phrases repeatedly.
Major symptoms of FTDEarly Stage
Dramatic change in personal & social conduct with lack of initiative, neglect of domestic, financial and occupational responsibilities.
Loss of empathy toward others (impaired “theory of mind.”)
Shallow affect or inappropriate jocular behavior, sing, dance, clap or recite phrases repeatedly.
Rigid, inflexible thinking and impaired judgment.
Major symptoms of FTDEarly Stage
Dramatic change in personal & social conduct with lack of initiative, neglect of domestic, financial and occupational responsibilities.
Loss of empathy toward others (impaired “theory of mind.”)
Shallow affect or inappropriate jocular behavior, sing, dance, clap or recite phrases repeatedly.
Rigid, inflexible thinking and impaired judgment. Disinhibition, loss of insight into personal and
social misconduct, sexual/moral transgressions.
Major symptoms of FTDEarly Stage
Repetitive or compulsive behavior Hypochondriasis, bizarre somatic complaints.
Major symptoms of FTDEarly Stage
Repetitive or compulsive behavior Hypochondriasis, bizarre somatic complaints. Excessive eating, gluttony, food fads (especially
craving for sweets) excessive alcohol intake.
Major symptoms of FTDEarly Stage
Repetitive or compulsive behavior Hypochondriasis, bizarre somatic complaints. Excessive eating, gluttony, food fads (especially
craving for sweets) excessive alcohol intake. Refusal to eat due to "negativism" or inability to
use motor skills needed for eating.
Major symptoms of FTDEarly Stage
Repetitive or compulsive behavior Hypochondriasis, bizarre somatic complaints. Excessive eating, gluttony, food fads (especially
craving for sweets) excessive alcohol intake. Refusal to eat due to "negativism" or inability to
use motor skills needed for eating. Change in sleep patterns, with prolonged
sleepiness, especially in those with apathetic behaviors.
Major symptoms of FTDMiddle Stage
Some individuals are overactive, restless, distractible and disinhibited.
Major symptoms of FTDMiddle Stage
Some individuals are overactive, restless, distractible and disinhibited.
Others are apathetic, inert, aspontaneous and emotionally blunted
Major symptoms of FTDMiddle Stage
Some individuals are overactive, restless, distractible and disinhibited.
Others are apathetic, inert, aspontaneous and emotionally blunted
These differences in outward activity disappear in the late stages of the disease.
Major symptoms of FTDLate Stage
A gradual reduction in speech, culminating in mutism.
Hyperoral traits.
Major symptoms of FTDLate Stage
A gradual reduction in speech, culminating in mutism.
Hyperoral traits. Failure or inability to make motor responses to
verbal commands.
Major symptoms of FTDLate Stage
A gradual reduction in speech, culminating in mutism.
Hyperoral traits. Failure or inability to make motor
responses to verbal commands. Akinesia (loss of muscle movement) and
rigidity with death due to complications of immobility.
Differences Between FTD and Alzheimer’s Disease
Differences in tissue pathology Differences in memory loss Differences in orientation Differences in visual-spatial skills Differences in intellectual abilities Differences in life expectancy Differences in genetics
Testing and Diagnosis Imaging and physical testing
CT and MRI Functional brain imaging and single
PET EEG Autopsy
TESTING AND DIAGNOSISNeuropsychological testing
Responses may be impulsive and tasks readily abandoned, while other patients may be slow, inert and persistent.
• May show poor mental effort and unconcern. Conversation not spontaneous; responses are brief
without elaboration, May make mechanical, repetitive remarks, echo
words spoken by others, or repeat responses. May have a weak voice and/or an odd or halting
speaking pattern. Overactive patients may be opposite, with.
unconstrained speech.
TESTING AND DIAGNOSISNeuropsychological testing
Visual-spatial skills remain normal except for those compromised by behavioral abnormalities.
Memory problems do not occur except as a result of ineffective use of memory.
Thought processes show impaired powers of abstraction, verbal response and design fluency.
Failure to respond or inappropriate responses not incomprehension, but concreteness of thinking or inattention.
Duration of FTD
Some patients decline rapidly over two to three years
Others show only minimal changes over a decade.
Studies have shown persons with FTD to live with the disease an average of 8 years, with a range from 3 to 17 years.
Management and Treatment of FTD
No medications are known currently to treat or prevent FTD
Behavior modification o Review driving competence o Monitor for eating non-food items o Caregiver education and
counseling
Management and Treatment of FTD
Environmental adjustmento Institutional care needed earlier
than in Alzheimer’so Structure area for pacing/ wanderingo Secure exitso Medical alert bracelet with
name/address/phone.
Management and Treatment of FTD
Pharmacological treatment of major types of frontal lobe pathologyo Irritable/disinhibited typeo Aggressive/psychotic typeo Apathetic/unmotivated type
o Depression/emotional incontinenceo Compulsive behaviorso Sexual disinhibition
EFC and relationship to FTD Frontal brain areas is seat of EFC. 30% of brain weight is responsible for
EFC. Not fully developed in children. Responsible for complex, goal-directed
actions. Responsible for initiation, execution and
monitoring of complex behaviors
Executive discontrol
Disorganized thoughts, behaviors and/or emotions.
Results in problem behaviors. Caused by many factors Is part of BPSD (behavioral and
psychological symptoms of dementia)