HAMPTON, Va. — When it was announced actor Bruce Willis had been diagnosed with frontotemporal dementia (FTD), it brought renewed attention to the disorder.
Jen Lewis wanted to know more and contacted a local neuropsychologist, Dr. Thomas Crum with Sentara Neurology Specialists. He told her he won’t see patients with FTD for a year or so, and then three or four patients will arrive all at once.
FTD is considered a rare type of dementia. It is also incredibly complex and not well known.
“When most people think about dementia, they think about Alzheimer’s disease [which] is very well studied," Dr. Crum explained. "There’s a fairly well-defined disease process that occurs. With frontotemporal dementia, there are multiple different disease processes that affect the brain in multiple different ways.”
It causes nerve damage in the front and temporal lobes of the brain.
There are three main FTD subtypes with their own unique manifestations: One involves changes in behavior and another impacts speech, language and communication. Symptoms of the third progress rapidly and show motor function difficulty.
Diagnoses can be challenging, as this type of dementia is so complicated.
“It is often, very often, misdiagnosed, especially initially,” said Dr. Crum. "Many people just misattribute the information, the symptoms, for psychiatric illness or lack of sleep or insomnia. It really does require thorough neurologic evaluation."
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It’s tough because FTD is the cause of only 10% to 20% of dementia cases and can strike at middle age, according to the Mayo Clinic.
“These are younger people. Often, it’ll hit right as they’re about to retire," Dr. Crum told me. "So, they have plans for the future that are amazingly disrupted and very quickly. You also have people at the height of their career when this starts to take a role. So, there’s a huge amount of loss.”
It's a loss for the patient and the patient’s family, and there is a small genetic component to frontotemporal dementia.
According to Dr. Crum, just 5% to 10% of people with the FTD gene will develop this disease.
Dr. Crum told Jen there are other risk factors.
“Repeated head injuries are one of the risk factors. Type 2 Diabetes is a risk factor, thyroid issues and autoimmune disorders are risk factors. There is also a study that showed people in the military have a greater risk," said Dr. Crum.
Some studies indicate men may have a higher probability of getting an FTD diagnosis as well. Treatment after diagnosis is generally palliative to manage symptoms. Right now, there are no medications that can cure or stop the progression of this type of dementia.
However, research regarding the prevention or delay of dementia, in general, is useful.
“All of the studies looking at diet have shown that engaging in a low carb, high protein, high omega-3 fatty acid diet is helpful in reducing inflammation in the brain,” Dr. Crum explained. "Exercise has also been found to be very, very helpful in reducing inflammation and improving the cerebral vascular functions within the brain."
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Dr. Crum mentioned active engagement as well to keep our cognition and brain healthy—using it so we don’t lose it. Taking care of our body and mind goes a long way in keeping disease at bay, including FTD and other types of dementia.
The Alzheimer's Association has additional information and available resources on frontotemporal dementia, for those click here.
