11 Signs of Frontotemporal Dementias or Pick’s Disease

By Valerie Feurich, Positive Approach to Care Team Member

Have you heard of the recent diagnosis of actor Bruce Willis with Frontotemporal Dementia (FTD)? Did that leave you wondering — what is FTD?

Frontotemporal Dementia, formerly referred to as Pick’s Disease, is an umbrella term for a variety of disorders that cause the frontal and temporal lobes of the brain to shrink.

Since these areas are responsible for a person’s behavior, personality, and language, people affected with FTD can undergo dramatic behavioral changes that negatively affect themselves and their care partners and family.

Since memory isn’t an issue at first and FTD tends to occur at a younger age than most other dementias (often between 40 and 75 years), dementia is often overlooked as a cause.

Getting an early and accurate diagnosis is key to managing future emotional, physical, and financial challenges, which is why we’ve put together a list of the eleven most common signs of Frontotemporal Dementias for you to be aware of:

1. Impulsive, Inappropriate Behaviors and Speech

Your frontal lobe, located behind your forehead, regulates your behaviors and impulses. As FTD begins to affect this area of the brain, people might suddenly begin to say rude or mean things to others, or become entirely uninhibited in pleasure-seeking activities such as eating, drinking, or sex.

2. Loss of Interpersonal Skills and/or Empathy

As FTD progresses, a person’s ability to see things from another person’s point of view diminishes. A previously compassionate and caring person might suddenly be non-responsive to another’s distress, or may no longer correctly respond to common social cues.

3. Apathy

Often mistaken as depression, a person with FTD might become fairly withdrawn, self-centered, and emotionally distant.

4. Decreasing Self-Awareness and Personal Hygiene

A person affected by FTD will have less and less self-awareness as the disease progresses. A lack of concern about their personal appearance is common, making them appear increasingly unkempt over time.

5. Lack of Reasoning and Logic (making poor decisions)

As the frontal lobe shrinks, a person’s ability to reason decreases while impulsivity increases, making it more likely for them to suddenly begin making unsafe or financially damaging decisions.

6. Repetitive Compulsive Behaviors

People living with FTD might develop Obsessive Compulsive Disorder (OCD), an anxiety disorder that is characterized by unwanted and repetitive thoughts, feelings, or behaviors that drive them to do something (compulsions).

7. Inability to Plan or Concentrate

Planning requires us to be able to think in a step-by-step process. When a person’s brain is affected by FTD, they are less and less able to concentrate and initiate steps to successfully sequence them (Step A => Step B => Step C, etc.).

8. Sudden and Frequent Mood Changes

A person with FTD might be sad one moment and euphoric just a short while later. Erratic and unpredictable mood changes can occur as the brain change progresses.

9. Speech and Language Difficulties

Depending on the type of FTD, a person’s ability to verbalize and comprehend language can become increasingly challenging as the temporal lobes begin to change. The affected person might speak very slowly, have trouble finding the right words, or be unable to name objects.

10. Balance and Movement Problems

Some types of FTD cause mobility problems similar to those observed with Parkinson disease. These can include muscle weakness, balance issues, tremors, rigidity, muscle spasms, and poor coordination.

11. Memory Loss

Unlike Alzheimer disease, those living with FTD commonly don’t suffer from memory issues and are able to keep track of day-to-day events until the condition progresses into a more advanced stage.

Always Remember:

Difficult behaviors displayed by a person living with a form of Frontotemporal Dementia are not out of ill will, but are symptoms of a changing brain.

If you have a family member or friend living with this condition, remind yourself that he/she has little or no awareness and is unable to control these challenging situations.

Planning ahead and learning how to manage challenging situations best can greatly help ease this difficult journey.

We’ve included a few excerpts of Teepa Snow’ s program Understanding Frontotemporal Dementias below to help you get started.

Enjoyed these excerpts? You can watch the full program online or on DVD.

Looking for more? Positive Approach to Care offers phone consultations, and your first 30-minute session is free of charge. Learn more at https://teepasnow.info/consult.

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Positive Approach to Care

Positive Approach to Care (PAC), founded by dementia care educator Teepa Snow, offers caregiver education through effective hands-on care skills and techniques.

Interested in learning more? Visit www.teepasnow.com/blog.