Frontotemporal Dementia (FTD)

FTD or Frontotemporal dementia is the leading cause of dementia in middle age. It strikes at a younger age than Alzheimer’s. Cases have been seen as early as 21 and as late as 80, but the disease typically hits during the 40s, 50s and 60s—when children are still in the home.

Unlike Alzheimer’s whose hallmark symptoms are short-term memory loss, FTD begins with changes in mood, personality, morals, belief systems, social conduct and language that are often mistaken as a 'mid-life crisis'. Families report that they feel like “a stranger has moved in” or that their loved one is “possessed.” Because memory and thinking initially remain intact, families hope their loved one will eventually “snap out of it.” They often seek couple’s counseling or family therapy.

People with FTD experience radical behavioral changes that are easily perceived as psychological crises. They become apathetic toward their families. They lose interest in their work. The parts of the brain that inform social interactions, assess consequences, and allow for self-reflection fail, leading to inappropriate social interactions and poor judgment. Bad financial decisions lead many families to bankruptcy. People with FTD lack awareness of their changes or the affects that these changes have upon the people around them. And, sadly, they lose the ability to care.

As the disease progresses, patients engage in bizarre behaviors. They have been known to eat food off of stranger's plates in restaurants, cast racial, ethnic and sexual slurs, switch religions, have illicit affairs and engage in frank criminal behavior. They often horde items, filling entire rooms full of found articles like dirty clothes, bottle caps or magazines. These peculiarly psychiatric symptoms make it difficult and embarrassing for families to take patients out in public, and because cognitive abilities remain intact early on, professionals often misdiagnose FTD as marital discord, stress or a mid-life crisis.

As difficult as the disease is, caregivers sometimes find an absurd kind of humor in it and some even discover a surprising gift. FTD gives some people a profound and uncharacteristic ability for visual creativity. Several people with FTD have become prominent artists during the course of their disease. Scientists hypothesize that the visual parts of the brain which had previously been mediated by demands of other mental functions may now be free to work unhindered.

To read about FTD in greater detail, please visit the UCSF Memory & Aging Center website.