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Frontotemporal Dementia Vs Alzheimer’s

The Effects Of Alzheimers On The Brain

What is frontotemporal dementia?

In people with Alzheimers disease, brain cells die and connections between brain cells may break down. One of the hallmark symptoms is abnormal protein deposits in the brain called plaques and tangles.

Plaques are dense clusters of protein that can block communication between neurons. Tangles are proteins that twist together that lead to the death of healthy brain cells.

In advanced Alzheimers, the brain shows significant shrinkage. Changes in the brain may occur a or more before symptoms start.

Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists can make the correct diagnosis up to 90 percent of the time.

The symptoms of Alzheimers and dementia can overlap, but there can be some differences.

Both conditions can cause:

  • behavioral changes
  • difficulty speaking, swallowing, or walking in advanced stages of the disease

Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis.

Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.

The Difference Between Alzheimers And Another Type Of Dementia

People not familiar with Alzheimers and frontotemporal dementia might use the terms interchangeably, but theyre actually two different diseases that not only have varying effects on behavior, but also look entirely different within a patients brain. Frontotemporal dementia affects the frontal and temporal lobes, which are behind the forehead and between the ears and responsible for judgment calls in social situations. Alzheimers, on the other hand, affects the hippocampus and the back of the brain, deep inside memory circuits. We spoke to Dr. Brad Dickerson, an associate professor of neurology at Harvard Medical School and a director in the neurology department at Massachussetts General Hospital, about why getting a diagnosis that distinguishes between Alzheimers and dementia is important for both patients and caregivers.

  • Alzheimers and dementia patients are affected in different parts of the brain, meaning they experience memory loss or personality changes in different ways.
  • Its important to differentiate between Alzheimers and frontotemporal dementia, or FTD, so that patients and families can know what to expect, receive targeted therapies and join the right support community.
  • People who receive a diagnosis of either disease in their 50s or earlier can feel marginalized if theyre not able to participate in their treatment plan.

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Being Patient:With FTD, is there memory loss that is apparent in the initial stage?

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.

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Outlook For Frontotemporal Dementia

How quickly frontotemporal dementia gets worse varies from person to person and is very difficult to predict.

People with the condition can become socially isolated as the illness progresses. They may not want to spend time in the company of others, or may behave in rude or insulting ways.

Home-based help will usually be needed at some stage, and some people will eventually need care in a nursing home.

The average survival time after symptoms start is around 8 to 10 years. But this is highly variable and some people live much longer than this.

If you or a loved one has been diagnosed with dementia, remember you’re not alone. The NHS and social services, as well as voluntary organisations and specialist support groups, can provide advice and support for you and your family.

Mri Acquisition And Volumetric Analysis

Frontotemporal Dementia (FTD) vs Alzheimer

In addition to AD-RAI, in this study, a novel MRI-based biomarker named FTDI was derived based on the volumetric results of brain regions with significant volume difference between AD and FTD using the NACC data.

To increase the comparability of the numerical metrics, the relative volumes of the involved brain regions and lobe atrophy Ri were normalized to Ri, i.e.,

where Ri is the relative volume of the ith volumetric brain measure of the jth subject among all the subjects from NACC included in this study. For the ease of formulation, assume values in the array Ri are arranged so that the first m values are the subjects with FTD and the total number of subjects with FTD and AD is n. The FTD dominant structures are the structures with statistically larger Ri values in the FTD group, and the AD dominant structures are those with statistically larger Ri values in the AD group. It should be noted that the FTD/AD dominant structures did not refer to the abnormal brain regions of FTD/AD patients. They were derived from the group-level comparisons and were the volumetric metrics with the statistically larger values. min and max represent the minimal and maximal values in the ith volumetric brain measure of all subjects from NACC included in this study, respectively.

where i = are the FTD dominant structures and i = are the AD dominant structures.

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Types And Locations Of Lesions

With Alzheimers disease, brain lesions appear on the inner face of the temporal lobe, especially in the hippocampus. From there, they spread to the rest of the temporal, parietal, and frontal lobes. As the name suggests, in the case of frontotemporal dementia, lesions appear on the temporal and frontal lobes.

Alzheimers involves a loss of neurons and synapses. In the brains of patients with Alzheimers, scientists have also identified the presence of tau proteins and amyloid proteins .

Frontotemporal dementia patients also experience a loss of neurons and synapses and an increase in the tau protein. However, some elements that arent part of Alzheimers disease, which are Pick cells and occasionally Pick bodies. Lastly, the amyloid proteins and neuritic plaque typical of Alzheimers disease are absent in frontotemporal dementia.

What Is Frontotemporal Dementia

Dementia describes a group of symptoms that can include problems with memory, thinking or language, and changes in mood, emotions and behaviour. It is caused when the brain is damaged by disease.

The word frontotemporal refers to the two sets of lobes in the brain that are damaged in this type of dementia. FTD occurs when disease damages nerve cells in these lobes.

This causes the connections between them and other parts of the brain to break down. The levels of chemical messengers in the brain also get lower over time. These messengers allow nerve cells to send signals to each other and the rest of the body.

As more and more nerve cells are damaged and die, the brain tissue in the frontal and temporal lobes starts to get smaller.

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What Are The Complications Of Frontotemporal Dementia

FTD is not life-threatening people may live with it for years. But it can lead to an increased risk for other illnesses that can be more serious. Pneumonia is the most common cause of death, with FTD. People are also at increased risk for infections and fall-related injuries.

As FTD progressively worsens, people may engage in dangerous behaviors or be unable to care for themselves. They may need 24-hour nursing care or to stay in an assisted living facility or nursing home.

Who Does It Affect

Frontotemporal Dementia

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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How Is Frontotemporal Dementia Diagnosed And Treated

Frontotemporal dementia can be hard to diagnose because symptoms are similar to other conditions. Also, because these disorders are rare, physicians may be unfamiliar with the signs and symptoms.

Talking with patients, family members, and caregivers can help doctors make a diagnosis. It is important to tell the doctor about any symptoms involving changes in personality and behavior and difficulties with speech or movement.

To diagnose frontotemporal dementia, a doctor may perform an exam and ask about symptoms, look at personal and family medical history, use tests to help rule out other conditions, order genetic testing, conduct an assessment of the mind and behavior, and order imaging of the brain. Only genetic tests in familial cases or a brain autopsy after a person dies can confirm a diagnosis of frontotemporal dementia. Researchers are studying ways to diagnose the disorders earlier and more accurately and to distinguish them from other types of dementia.

There is no cure for frontotemporal dementia and no way to slow down or prevent it. However, there are ways to help manage symptoms:

Support groups can also be a valuable resource for people with frontotemporal dementias and their caregivers, allowing them to share experiences and tips with others who may be in the same situation. Nonprofit organizations and community organizations may provide online or in-person support groups. Alzheimers Disease Research Centers may also offer education and support groups.

What Are The Symptoms Of Behavioural Variant Ftd

This is the most common type of frontotemporal dementia. In the early stages it mainly causes changes in someones personality and behaviour.

A person with behavioural variant FTD may:

  • lose motivation to do things that they used to enjoy
  • struggle to focus on tasks and become distracted easily
  • find it difficult to plan, organise and make decisions these problems may first appear at work or with managing money
  • lose their inhibitions behaving in socially inappropriate ways and acting impulsively or without thinking. For example, making insensitive or rude comments about someones appearance, making sexual gestures in public, staring at strangers, or being verbally or physically aggressive
  • lose the ability to understand what others might be thinking or feeling they may be less considerate of the needs of others, lose interest in social activities or be less friendly. They may also have less of a sense of humour or laugh at other peoples problems. This can make the person appear cold and selfish
  • show repetitive or obsessive behaviours for example, repeating phrases or gestures, hoarding or being obsessed with timekeeping. They may also take up new interests for example, music or spirituality. These might give the person a positive focus but can become obsessive in nature
  • crave sweet, fatty foods or carbohydrates and forget their table manners. They may also no longer know when to stop eating, drinking alcohol or smoking.

Primary progressive aphasia

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What Is The Life Expectancy Of Ftd

The average life expectancy after a diagnosis of FTD is 7.5 years. But the condition can progress faster or slower. Your healthcare provider is the best person to tell you more about the progress of the disease and the likely timeline. They can also update you throughout the course of the disease if it progresses faster or slower than expected.

Difference : Age Of Onset

The behavioural variant frontotemporal dementia (bvFTD) syndrome in ...

Alzheimers disease strikes people who are aged 65 and older. Advancing age is the number one risk factor for developing Alzheimers disease. However, Alzheimers is not a normal aspect of aging. Early onset Alzheimers disease is also possible in younger age groups, specifically those under 65.

Symptoms of frontotemporal dementia can start in younger people, primarily those between the ages of 40 and 65. Younger adults as well as older adults are not immune to the disease, either. Certain types of frontotemporal dementia can emerge in people who are in their 20s as well as 80s.

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How Does Ftd Differ From Alzheimers Disease

Different symptoms.

FTD brings a gradual, progressive decline in behavior, language or movement, with memory usually relatively preserved.

It typically strikes younger.

Although age of onset ranges from 21 to 80, the majority of FTD cases occur between 45 and 64. Therefore, FTD has a substantially greater impact on work, family, and finances than Alzheimers.

It is less common and still far less known.

FTDs estimated U.S. prevalence is around 60,000 cases , and many in the medical community remain unfamiliar with it. FTD is frequently misdiagnosed as Alzheimers, depression, Parkinsons disease, or a psychiatric condition. On average, it currently takes 3.6 years to get an accurate diagnosis.

How Is Frontotemporal Dementia Treated

Currently, no treatments are available to cure or slow the progression of FTD, but healthcare providers may prescribe medicine to treat symptoms. Antidepressants may help treat anxiety and control obsessive-compulsive behaviors and other symptoms. Prescription sleeping aids can help ease insomnia and other sleep disturbances. Antipsychotic medicine may reduce irrational and compulsive behaviors.

Behavior modification may help control unacceptable or risky behaviors.

Speech and language pathologists and physical and occupational therapists can help adjustment to some of the changes caused by FTD.

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Frontotemporal Dementia Versus Alzheimers Disease

AD is the most common dementia in older people. Therefore, it is often one of the first diseases a doctor considers. But Alzheimers disease usually begins with memory loss, while FTD is typically a behavior or language disorder.

  • The probability of AD is strongly affected by the age of the person showing the symptoms. The odds of having Alzheimers disease increase markedly the older you get, while the odds for FTD may decrease with age.
  • FTD often begins with distinct behavioral changes while people with Alzheimers disease in the early stages tend to remain socially skillful despite their memory problems . In advanced AD, people generally have trouble managing their finances, show poor judgment and irritability, and may become equally difficult to manage as people with FTD.
  • Apathy in AD patients is milder, whereas apathy in FTD patients is more pervasive and more often reflects a lack of concern for others or lack of initiative.
  • People with AD usually have an early and profound difficulty learning and retaining new information. As the disease progresses, memory for new and old information is lost. These memory problems may lead to language problems as well, but the root is a problem remembering. In contrast, most mildly impaired FTD patients generally know the day or time and their location, and they are able to keep track of recent events. They may not test well, but that may be due to lack of concern or effort in the testing situation.

Is Ftd Worse Than Alzheimer’s Disease

Frontotemporal Dementia

FTD and Alzheimers disease are both conditions that can severely affect and disrupt a persons life. Generally, FTD affects people at a younger age than Alzheimers disease. But theres no way to define whether one condition is better or worse than the other because these conditions affect everyone differently.

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Causes Of Frontotemporal Dementia

Frontotemporal dementia is caused by clumps of abnormal protein forming inside brain cells. These are thought to damage the cells and stop them working properly.

The proteins mainly build up in the frontal and temporal lobes of the brain at the front and sides. These are important for controlling language, behaviour, and the ability to plan and organise.

It’s not fully understood why this happens, but there’s often a genetic link. Around 1 in 8 people who get frontotemporal dementia will have relatives who were also affected by the condition.

If you have a family history of frontotemporal dementia, you may want to consider talking to your doctor about being referred to a geneticist and possibly having a genetic test to see if you’re at risk.

There’s a lot of research being done to try to improve understanding of the causes of frontotemporal dementia so treatments can be discovered.

If you’re interested in helping with research, you can speak to a doctor or register your interest on Join Dementia Research.

Living With Frontotemporal Dementia

Coping with FTD can be frightening, frustrating, and embarrassing for the patient and family members. Since some symptoms cant be controlled, family members shouldn’t take their loved ones behaviors personally. Families need to maintain their own well-being, while ensuring that their loved one is treated with dignity and respect.

Caregivers should learn all they can about FTD and gather a team of experts to help the family meet the medical, financial, and emotional challenges they are facing.

Its important to find a healthcare provider knowledgeable about FTD. Other healthcare specialists who may play a role on the team are home care nurses, neuropsychologists, genetic counselors, speech and language therapists, as well as physical and occupational therapists. Social workers can help the patient and caregivers find community resources, such as medical supplies and equipment, nursing care, support groups, respite care, and financial assistance.

Attorneys and financial advisors can help families prepare for the later stages of the disease.

Advanced planning will help smooth future transitions for the patient and family members, and may allow all to participate in the decision-making process.

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