Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
What Is Frontal Lobe Dementia
The frontal lobes of the brain are located as the name suggests at the front of the brain. Loosely speaking, it contains what we call the higher functions of the brain. These are the areas of the brain responsible for emotions, understanding, speech some types of movement, planning and judgement in other words the things which make you a person, and personality. Like all dementias the people who develop symptoms face a slow loss of self and those who care for them, losing the person they care for by slow degrees.
Frontal lobe dementia is also known as frontotemporal dementia , or frontotemporal degeneration, it is an overarching term for several categories of a loss of brain function. The changes to the brain are caused by an abnormal build-up of tau proteins, which stop the brain cells from functioning properly, so they die. In frontal lobe dementia parts of the frontal and temporal lobes of the brain are damaged. It was previously known as Picks disease after the doctor Arnold Pick who identified and first documented the symptoms in a patient over a hundred years ago in 1892.
Unlike the most widely diagnosed form of dementia, Alzheimers disease, frontal lobe dementia occurs at a much younger age and is partly genetic. That means while there is no certainty that if you have had a close blood relative with FLD you will get it too, your chances of developing it are much higher than for other members of the population.
What Are The Symptoms Of Frontotemporal Dementia
Frontotemporal dementia affects everyone differently. Its symptoms vary a lot and depend on which areas of the frontal and temporal lobes are damaged and so the type of FTD the person has.
As with most forms of dementia, FTD is progressive. This means its symptoms may be mild at first, but they will get worse over time.
Find out more about FTD symptoms below.
Behavioural variant FTD
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Alzheimers Vs Dementia Symptoms
While many symptoms of Alzheimers and Dementia are similar, there are some differences that are worth pointing out.
Both Alzheimers and Dementia symptoms include:
- Struggles with the ability to think
- Memory Impairment
Alzheimers Symptoms only include:
- Struggles remembering events and conversations that recently happened
- Changes in behavior
- Difficulty speaking
Many of these Alzheimers symptoms are shared by other types of Dementia. So how can you tell which are symptoms of Dementia vs. Alzheimers? Usually, it is because they include or exclude other initial symptoms that help doctors confirm which type of Dementia individuals have.
Who Does It Affect
Frontotemporal dementia is an age-related condition, but it happens sooner than most age-related conditions that affect your brain. Most people develop FTD conditions between the ages of 50 and 80, and the average age when it starts is 58.
Overall, FTD appears to affect males and females equally. However, the three conditions under FTD dont affect people assigned male at birth and people assigned female at birth equally. Males are more likely to develop bvFTD and svPPA, and females are more likely to develop nfvPP and corticobasal degeneration. FTD is also a condition that can run in families, with about 40% of cases happening in people with a family history of FTD.
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There Are Two Broad Types Of Frontotemporal Dementia:
- Behavioural variant FTD where damage to the frontal lobes of the brain mainly causes problems with behaviour and personality. These lobes are found behind the forehead and process information that affects how we behave and the control of our emotions. They also help us to plan, solve problems and focus for long enough to finish a task.
- Primary progressive aphasia occurs when damage to the temporal lobes on either side of the head nearest the ears causes language problems. This part of the brain has many roles. A key function of the left temporal lobe is to store the meanings of words and the names of objects. The right temporal lobe helps most people recognise familiar faces and objects.
The first noticeable symptoms for a person with FTD will be changes to their personality and behaviour and/or difficulties with language.
These are very different from the early symptoms of more common types of dementia. For example, in Alzheimers disease, early changes are often problems with day-to-day memory. In the early stages of FTD, many people can still remember recent events.
Screening And Neuroimaging To Aid Diagnosis
Recent findings published in Alzheimers Disease and Associated Disorders suggest that the Montreal Cognitive Assessment may be a valuable tool in distinguishing FTD from AD.2 The results show a significant difference in overall scores between the 2 patient groups , and the following specific MoCA items differed between AD and FTD: serial 7 subtractions , delayed recall , and orientation .
For bvFTD in particular, the criteria developed by the International Behavioural Variant FTD Criteria Consortium , revised in 2011, have shown high diagnostic accuracy for probable bvFTD .3,4
In establishing a diagnosis in suspected cases of FTLD, neuroimaging is a key component. Dr Shulman described the following defining imaging patterns of FTLD:
- The majority of patients have focal frontal or anterior temporal atrophy that is readily identifiable by visual inspection. The atrophy is often asymmetric, even in patients with bvFTD.
- Lateralized findings are almost always present in patients with PPA, encompassing a wide network of brain regions. The whole left peri-Sylvian region, anterior temporal lobes , and basal ganglia bilaterally are all found to be atrophied in PPA patients.
- In PNFA, the inferior frontal lobe and insula are atrophied, while in semantic dementia, the anterior temporal lobe is focally atrophied.
- FDG-PET imaging demonstrates variable patterns of frontal and temporal hypometabolism in contradistinction to the biparietal hypometabolism most commonly seen in AD.
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Assessment Of Neuropsychiatric Features
A questionnaire was designed following a review of the literature to determine the neuropsychiatric symptoms that are commonly reported in FTD and/or AD. It incorporated questions related to symptoms reported in our previous studies of frontal dementia, components from the neuropsychiatric inventory, and specific questions relating to stereotypic behaviour.
After initial piloting, the final version of the questionnaire consisted of 39 questions investigating the following broad domains: depression, elation, irritability, anxiety, aggression, distractibility, executive functioning, risk taking, empathy, apathy, ritualistic/stereotypic behaviour, aberrant motor behaviour, disinhibition, social withdrawal, hallucinations, delusions, changes in food preference, personal care, and sleep patterns .
Carers were asked to rate the frequency of a behaviour on a scale of 03. Where a score of zero referred to no change a score of 1 to occasional occurrence 2 to a frequent problem and 3 to a severe behavioural problem. The questionnaire was scored by totalling the carer ratings for all the questions relating to each neuropsychiatric feature this gave an idea of the prevalence of each of the symptoms.
Test-retest reliability was established by asking 14 of the carers to complete a second questionnaire, 1 week after the first, without reference to it. We found an overall high degree of reliability which applied to each of the three patient groups: AD , semantic dementia , fv FTD.
The Difference Between Frontal Lobe Dementia And Alzheimer’s Disease
There are differences between frontal lobe dementia and Alzheimers, just like there are differences in many other cognitive disorders. Dementia represents a group of different memory disorders in senior citizens, and Alzheimers disease is a form of dementia. It is known that Alzheimers disease makes up over 50% of all registered dementia related cases. So, although a large percentage of memory loss can be credited to Alzheimers disease, it can also be caused by atherosclerosis, neurological disorders, and strokes. It is possible to slow down Alzheimers disease by medication and non-drug treatments. In general, when doctors are treating Alzheimers patients, they are normally trying to treat the symptoms that it is causing. Most dementia related disorders can be controlled by eating healthy foods with smaller portions, and through regular exercise. At Applewood Our House in Lakewood, Golden and Arvada, we have dietician created menus for our residents and many exercise related programs. In addition, patients who stop smoking and cut down on alcohol or quit, will notice immediate benefits. Dementia that is caused by heart problems and other cardiovascular issues can be helped by lowering the blood pressure.
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How Can I Ensure My Wishes Are Followed When I Cant Choose Myself
If you have an early diagnosis of frontotemporal dementia of any kind, you may want to talk to your healthcare provider, your family or loved ones, and to anyone you trust to make important decisions for you. These discussions are important because they can help you ensure caregivers can honor your wishes if you cant choose for yourself in the future.
While these conversations often feel unpleasant or difficult, having them sooner rather than later can help avoid confusion about what you want for yourself in the years to come. They also mean your loved ones don’t face the painful, difficult situation of having to guess what you wanted.
In addition to those conversations, you should also put your wishes and decisions in writing. That includes preparing documents connected to legal issues and what happens if you can’t care for yourself or make decisions for your care or well-being. Many people choose to consult an attorney when preparing these documents. However, many of these are ones you can prepare on your own .
Be A Part Of Finding Better Treatments
Do you or a family member have frontotemporal dementia? Researchers are looking for people like you to participate in a study to track disease progression and advance treatments the ARTFL-LEFFTDS Longitudinal Frontotemporal Lobar Degeneration Research Consortium.
What Causes Frontotemporal Dementia
Although it has been linked to a variety of gene mutations, the cause of FTD remains unknown. Physicians may use multiple tests to identify characteristics of FTD and rule out other possible conditions, such as liver or kidney disease. Standard testing may involve blood work, MRI, CT scan, PET scan and neuropsychological testing.
Ensemble Classifier And Cross
As shown in Figure 5, there can be as much as 3% difference in the classification accuracy across the individual classifiers trained with a different subdivision of the training and validation set, suggesting an unstable performance of each single classifier. In all four experiments, the ensemble classifier had the highest or close to highest accuracy, suggesting that the ensemble strategy improves the robustness and generalizability of the classifier.
It was worth mentioning that with the GAN, the variation of classification accuracy with individual classifiers decreased to 0.49% while the accuracy of ensemble classifier was 88.28%, suggesting that, with using GAN for data augmentation, the complex co-adaptations to training or validation set were reduced. The ensemble classifier strategy, although still effective, could therefore be optional with the application of GAN in light of limitations of available computational resources.
On top of the combination of GAN-based data augmentation and cross-validation-based ensemble classifier, an additional nested 10-fold cross validation was implemented to ensure the proposed method is properly validated. Nevertheless, it would be ideal to validate the proposed multi-class classifier on an entire independent and well-homogenized dataset to best evaluate its generalizability toward unseen dataset .
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What Can I Expect If I Have This Condition
FTD is a degenerative brain disease. That means that the effects on your brain get worse over time. Memory loss isnt usually a problem until later in the disease, but other symptoms and effects are likely. Depending on the type of FTD you have, youll likely lose one of the following:
- Control over your behavior.
- Ability to speak.
- Ability to understand others when they speak.
People with FTD commonly also develop a problem known as anosognosia. This means lack of insight, and it causes a problem with how your brain processes symptoms or evidence that you have a medical condition. That means you lose the ability to tell that you have a medical condition and to understand what this means for you in the long run.
Because this condition gradually affects your ability to control your actions or communicate, most people who have it eventually can’t live independently. Commonly, people with this condition need 24/7 skilled medical care, such as in a skilled nursing facility or long-term care setting.
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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What Is Alzheimers Disease
Alzheimers Disease is a disorder in the brain that affects your memory, thinking, and behavior. Researchers believe that over 6 million Americans over 65 years of age are currently diagnosed with Alzheimers.
Alzheimers Disease is the most common form of Dementia and the 6th leading cause of death within the US. Not only does it affect your cognitive abilities, but it affects your day-to-day activities.
- Symptoms of Alzheimers Disease
Memory loss is the number one symptom of Alzheimers Disease. The symptoms that are most common in Alzheimers are:
- Causes of Alzheimers Disease
Alzheimers Disease is caused by abnormal buildups of proteins that form amyloid plaques and tangles. Researchers believe that this begins about ten years before the first noticeable symptom. In individuals with Alzheimers Disease, researchers notice that healthy neurons stop functioning and lose connection with other neurons, which causes them to die. The initial damage caused by Alzheimers Disease occurs in the hippocampus and the entorhinal cortex. This is where many of your memories are formed, which is why individuals with Alzheimers Disease see a loss of memory as one of the first symptoms.
- Stages of Alzheimers Disease
There are seven stages of Alzheimers Disease.
Stage 1: Before Symptoms are seen
Stage 2: Becoming forgetful
Stage 3: Noticeable Memory Changes
Stage 4: Cognitive Changes
Stage 5: Loss of Independence
Stage 6: Severe Alzheimers Disease
Signs And Symptoms Of Frontotemporal Dementia
Each case of FTD is different, but the illness generally becomes more distinguishable from other brain conditions as it progresses. Symptoms may occur in clusters, and some may be more prevalent in early or later stages. Here is a list of ten signs of FTD:
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Data Augmentation With Generative Adversarial Network
In deep/machine learning, a common strategy to increase the number of training samples and prevent overfitting is data augmentation. Operations, such as rotation, flip, and zooming, are commonly used for 2D image recognition. However, those operations can hardly be used on a 1D feature vector. GAN have emerged to be a powerful tools to synthesize new data and have gained popularity in the generation of realistic natural images, and has also shown great potential to be a powerful data augmentation technique to synthetic image data with more variation and improve the generalizability of the machine learning algorithm . Therefore, we investigated the possibility of applying GAN for 1D structural brain feature augmentation for the improvement of classification performance in this study.
Figure 2. Architecture of generative adversarial network. The numbers of units of Generator layers are 512 and 3,449, respectively.
To prevent potential problems due to vanishing gradients, the generator consists of two layers, a single hidden layer and an output layer. Both layers are fully connected layer with 512 and 3,449 units, respectively. The dimension of random noise was set to 100 with each element set to follow a normal distribution. The activation function for the first layer was a rectified linear unit to avoid gradients from vanishing, while the one for the second layer was tanh function to squash the synthesized data into the same range of the real data.
What Are The Types Of Frontotemporal Dementia
There are several disorders that can result in frontotemporal dementia, all of which can affect middle-aged and older adults.
- Behavioral variant frontotemporal dementia is the most common frontotemporal disorder. It causes changes in personality, behavior, emotions, and judgment.
- Primary progressive aphasia involves changes in the ability to communicate to speak, read, write, and understand what others are saying.
- Movement disorders happen when the parts of the brain that control movement are affected. There are two types of rare movement disorders associated with FTD: corticobasal syndrome and progressive supranuclear palsy. Other movement-related disorders include frontotemporal dementia with parkinsonism and frontotemporal dementia with amyotrophic lateral sclerosis . Symptoms can vary among these movement disorders.
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How Does This Condition Affect My Body
FTD affects your brain’s frontal and temporal lobes in the early and middle stages of the disease. As FTD affects those lobes, you lose certain abilities because neurons in those areas stop working.
Your frontal lobe, located right behind your forehead, is responsible for the following:
- Changes in diet or mouth-centered behaviors.
- Loss of executive function.
Loss of inhibitions
Inhibition is when your brain tells you not to do something. Losing your inhibitions because of frontal lobe deterioration can look like any of the following:
- Loss of the filter for what you say. When this happens, you might say hurtful, rude or offensive things. For some people, this can seem like a major personality shift.
- Lack of respect for others. This often involves getting too close to people or touching them in unwelcome ways. Inappropriate sexual comments or actions are also common.
- Impulsive actions and behaviors. These are usually risky behaviors, such as reckless gambling or spending. Criminal behaviors like shoplifting are also possible.
Healthcare providers commonly mistake apathy for depression because the two have many similarities. Apathy tends to look like the following:
- Loss of motivation.
Loss of empathy
People who have a loss of empathy may have trouble reading the emotions of others. That may look like theyre behaving in a cold, unfeeling or uncaring way.
Changes in diet or mouth-centered behaviors
Primary progressive aphasia