What Is Frontal Lobe Dementia?

Dementia is a term that encompasses a range of conditions affecting cognitive function, behaviour, and daily living skills. Among these, frontal lobe dementia, also known as frontotemporal dementia (FTD), is a less common but significant type that presents unique difficulties for those living with the condition and their loved ones. At KYN, we understand the importance of providing specialised dementia care for individuals living with various forms of dementia, including FTD. In this comprehensive guide, we explore its symptoms, causes, and impact on daily life.

Understanding Frontal Lobe Dementia

Frontal lobe dementia, or frontotemporal dementia, is a group of conditions caused by progressive nerve cell loss in the brain's frontal lobes (behind the forehead) or its temporal lobes (the regions behind the ears). This type of dementia primarily affects behaviour, personality, and language skills, rather than memory, which distinguishes it from living with more common forms of dementia such as Alzheimer's disease. FTD is sometimes referred to as Pick's disease, named after Arnold Pick, who first described the condition in 1892.

Symptoms of Frontal Lobe Dementia

The symptoms of living with frontotemporal dementia can vary significantly from person to person, depending on which areas of the frontal and temporal lobes are affected. However, there are some common signs and symptoms associated with living with FTD:

Behavioural Changes

One of the hallmark symptoms of living with frontal lobe dementia, particularly in the behavioural variant, is a marked change in personality and behaviour. These changes can be difficult for both the individual and their loved ones. Some common behavioural symptoms include:

• Lack of inhibition: People living with FTD may act impulsively, saying or doing things that are socially inappropriate.
• Apathy: There may be a loss of motivation and interest in previously enjoyed activities.
• Emotional blunting: Individuals might show reduced empathy or emotional responsiveness.
• Compulsive behaviours: Repetitive or ritualistic actions may develop, such as hoarding objects or following strict routines.
• Changes in eating habits: This can include overeating, developing a preference for sweet foods, or even putting inedible objects in the mouth.

These behavioural changes often occur early in the course of living with FTD and can be mistaken for psychiatric disorders, leading to delays in diagnosis.

Language Difficulties

For those living with primary progressive aphasia, language problems are the primary symptom. These can manifest in different ways:

• Difficulty finding the right words (anomia)
• Problems with speech fluency
• Impaired comprehension of complex sentences
• Difficulty recognising familiar objects or people (in semantic variant PPA)
• Errors in grammar and sentence construction

As the condition evolves, some individuals may lose the ability to speak entirely, relying on non-verbal forms of communication.

Cognitive Changes

While memory is often less affected in the early stages of FTD compared to living with other types of dementia, cognitive changes do occur:

• Difficulty with planning and organising
• Impaired judgement and decision-making
• Problems with attention and concentration
• Difficulty with abstract thinking
• Reduced mental flexibility

These cognitive changes can significantly impact a person's ability to manage daily tasks and maintain independence.

Motor Symptoms

In some forms of FTD, particularly those associated with movement disorders, individuals may experience:

• Muscle weakness and stiffness
• Difficulty with coordination and balance
• Tremors or muscle spasms
• Difficulty swallowing (dysphagia)

These motor symptoms can develop gradually and may become more pronounced in time . Types of Frontotemporal Dementia Living with frontotemporal dementia is not a single condition but rather a spectrum of disorders. The three main types of FTD are:

Behavioural variant FTD (bvFTD)

This is the most common form of FTD, primarily affecting behaviour and personality. People with bvFTD may experience significant changes in their social conduct, empathy, and decision-making abilities.

Primary Progressive Aphasia (PPA)

This type of FTD primarily affects language skills. PPA is further divided into two subtypes:

• Semantic variant PPA (svPPA): Also known as semantic dementia, this subtype affects the ability to understand the meaning of words and recognise objects.
• Non-fluent variant PPA (nfvPPA): This subtype impacts a person's ability to speak fluently and articulate words correctly.

FTD Movement Disorders

Some forms of FTD are associated with movement problems. These include:

• Corticobasal syndrome (CBS)
• Progressive supranuclear palsy (PSP)
• FTD with amyotrophic lateral sclerosis (FTD-ALS)

Understanding these different types of FTD is crucial for accurate diagnosis and appropriate care planning.

Treatment and Management of Frontotemporal Dementia

While there is currently no cure for living with  frontotemporal dementia (FTD), various non-pharmacological approaches can help manage symptoms and improve quality of life:

Non-Pharmacological Approaches

Various therapies and interventions can be beneficial:

• Speech and language therapy for communication difficulties
• Occupational therapy to maintain daily living skills
• Physical therapy for movement problems
• Cognitive stimulation activities
• Music or art therapy

Physical exercise and activities that the person enjoys or finds useful are often the most effective ways of helping a person living with FTD maintain a good quality of life.

Supportive Care

As the condition evolves, increasing levels of care will be needed. This might involve:

• Home care services
• Respite care
• Eventually, full-time residential care in a specialised home like KYN

When someone has problems with movement or co-ordination, support from a physiotherapist or occupational therapist can also be particularly helpful. It's important to note that drugs commonly used to treat other types of dementia are not recommended for people with FTD. Cholinesterase inhibitors (such as donepezil, rivastigmine, galantamine) can actually make the symptoms of living with FTD worse.

Frontotemporal Dementia Support at KYN

Living with frontotemporal dementia presents significant difficulties for those affected and their loved ones. Understanding the symptoms, causes, and management strategies is crucial for providing appropriate care and support. At KYN, we are committed to offering specialised care for individuals living with FTD and other forms of dementia, focusing on maintaining dignity, quality of life, and individualised care plans. For more information about our specialised dementia care services at KYN, including our approach to supporting individuals living with frontotemporal dementia, please contact us. Our team is here to provide guidance, support, and compassionate care tailored to each individual's unique needs.