Help with Fronto-temporal dementia in later life.
Suppose you are alone at night and the electricity cuts out. You’d find a torch, check the fuse box and ring the electricity supplier. This is not a solution you’d have learned – your brain would easily be able to come up with it there and then. But in the case of someone with fronto-temporal Dementia, creating solutions to unexpected or new experiences may be a struggle.
This form of dementia, affecting the front parts of the brain, is relatively rare. Your memory may remain normal, but your behaviour or personality may change. Because it develops very slowly, early diagnosis is important to help people adapt to and live with the changes they are experiencing.
Symptoms usually start very slowly and develop over time. Common symptoms of Fronto-Temporal Dementia include:
- inability to think flexibly or cope with new situations
- argumentativeness and aggression
- sexual inappropriateness and loss of inhibitions
- disorganisation and inability to care for oneself
- speech problems
What are the causes?
The cause is not known, but there are probably a number of them. In some cases a protein called tau accumulates in the brain. Some (but by no means all) are inherited through faulty genes. Picks Disease is a subtype of Fronto-Temporal Dementia.
Key facts about Fronto-Temporal Dementia
- It is a relatively rare cause of dementia; affecting around 18,000 people in the UK
- It affects younger people compared to most other types of dementia – usually starting when people are in their 50s or 60s.
- The early symptoms are subtle and may be put down to “mid-life crisis”
- It is genetically inherited in about 10% of cases
- There are three subtypes: Behavioural Variant; Aphasic and Semantic Dementia
People with Fronto-Temporal Dementia are unlikely to be aware of the problems they face and may not be keen to seek help. However those around them will notice problems with work, especially when this involves concentrating or making decisions; problems with social interactions (often with family and friends being alienated because of rudeness or irritability) and difficulty with doing day-to-day tasks. The problems will be subtle in the first few years. The effects will vary depending on the condition; the Behavioural Subtype may result in impulsive or disinhibited behaviour or apathy; Aphasic Subtype means people have problems speaking fluently and in the Semantic Subtype people lose understanding for words.
How is it diagnosed?
Some of the symptoms of Fronto-Temporal Dementia also occur in other conditions (like depression, mania, or anxiety) so it is important to see a doctor experienced in diagnosing dementia.
The doctor will take a full account of how the symptoms started and progressed and will want to do some brain function (cognitive) tests. It is also important to get the views of someone who knows the patient well. An MRI brain scan can be very helpful in many cases, and sometimes a special scan (SPECT or PET) of blood flow in the brain can help.
What is the treatment for Fronto-Temporal Dementia?
People with Fronto-Temporal Dementia need a team of specialists to help them. At the moment there are no drug treatments (although some are in the pipeline) specifically for this type of dementia.
A main part of treatment is helping the person, and their family, understand what the diagnosis is and how it will affect them. Psychological effects (such as behaviour change) can benefit from the help of a psychologist or psychiatrist. A speech and language therapist can provide practical advice if speech is affected, and an occupational therapist can help, for example by making sure the home is safe and providing adaptations for daily tasks. Occasionally, medication such as antidepressants or tranquillisers may be needed.
People with FTD and their families will need counselling and advice about planning for the future; for example, how to set up a Lasting Power of Attorney.
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