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Frontotemporal dementia/frontal lobe dementia

Think of dementia and you probably think of older people. Alzheimer's disease is the most common cause of dementia and mainly affects people over 65. However, not all dementia is due to Alzheimer's. In fact there are over 100 different types of dementia, some rarer than others, and some more likely to affect younger people.

There are more than 40,000 people in the UK under 65 years of age who have young-onset dementia and of them, frontotemporal dementia is probably the third most common cause of their symptoms. It is a progressive disease and has recently been in the news after John Berry, a founder member of the Beastie Boys, died of frontotemporal dementia at the age of 52.

What is frontotemporal dementia?

Frontotemporal dementia happens when abnormal proteins clump together causing nerve cells in the lobes at the front and/or sides of the brain to die and the pathways that connect them to change. There is also some loss of important chemical messengers.

Frontotemporal dementia is also known as Pick's disease.

It is most often diagnosed between the ages of 45 and 65, but younger or older people can also be affected.

Experts believe the disease is due to a mixture of medical and lifestyle factors. In around 30% to 40% of people with this type of dementia, there is good evidence the disease is genetic.

It affects men and women about equally.

Symptoms of frontotemporal dementia

The typical symptoms of frontotemporal dementia include:

  • Changes in personality and behaviour
  • Difficulties with language.

Initial symptoms can be very subtle, but they slowly get worse over the years as the disease progresses.

There are three different types:

Behavioural variant frontotemporal dementia - which causes changes in personality and behaviour first. A person may lose their inhibitions along with their motivation. They may make inappropriate comments, struggle to make decisions, overeat and crave sweet or fatty 'junk' foods. They tend not to have problems with day-to-day memory.

Progressive non-fluent aphasia - language is affected first but this symptom only becomes apparent slowly, often over 2 or more years. Common early symptoms may include, slow, hesitant speech, errors in grammar and a failure to understand complex sentences, although not single words. Memory tends to be well preserved in the early stages.

Semantic dementia - language is affected first but, again, this symptom may only become apparent over a period of a couple of years or more. Speech remains fluent but common early symptoms can include people losing their vocabulary and their knowledge of words so they may ask what, for example, book, means. Memory tends to be well preserved in the early stages.

As frontotemporal dementia progresses, differences between the different types become much less obvious as the symptoms progress. In the later stages symptoms are often similar to those of the later stages of Alzheimer's disease. The person may become increasingly less interested in people and things. They may also have limited communication. They may no longer recognise friends and family and are likely to need full-time care.

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