Frontotemporal Dementia (FTD)

Frontotemporal dementia (FTD) refers to a group of progressive neurological disorders caused by damage to nerve cells in the brain’s frontal and temporal lobes. These areas help control personality, behavior, language, social awareness and executive function. As FTD progresses, people may have increasing difficulty communicating, managing emotions, making decisions or completing daily activities.

FTD can look different from stroke, Alzheimer’s disease or other memory disorders because early symptoms may involve behavior or language rather than memory loss. A careful neurological evaluation can help distinguish FTD from other causes of cognitive or behavioral change.

FTD is an umbrella term for several related conditions. The type a person has depends on which brain networks are affected first and which symptoms are most prominent.

Common types include:

• Behavioral variant FTD: The most common form, often causing changes in personality, judgment, impulse control, empathy or social behavior.
• Primary progressive aphasia: A language-focused form that affects speaking, understanding, reading or writing.
• Movement-related FTD: Some people develop symptoms that resemble Parkinsonism, amyotrophic lateral sclerosis (ALS) or other movement disorders.

Because these forms can overlap, diagnosis often requires input from neurology, neuropsychology, speech-language pathology and other specialists.

FTD symptoms vary by type and can develop gradually. Families may notice that a person seems “different” before obvious memory problems appear.

Symptoms may include:

• Personality or behavior changes, such as impulsivity, apathy, loss of empathy or poor judgment.
• Repetitive behaviors, compulsions or changes in eating habits.
• Trouble finding words, forming sentences or understanding language.
• Difficulty planning, organizing, solving problems or managing work and finances.
• Mood or emotional changes that may be mistaken for depression or another psychiatric condition.
• Movement changes, including stiffness, weakness, tremor, falls or coordination problems.

Symptoms that come on suddenly, such as facial drooping, arm weakness or speech trouble, may signal a stroke and require emergency care.

FTD disorders develop when abnormal proteins build up in brain cells, leading to progressive cell damage and shrinkage in the frontal and temporal lobes. The exact cause is not always known, but genetics can play a role.

Risk factors may include a family history of FTD, early-onset dementia, ALS or other related neurological disorders. FTD often begins between ages 40 and 65, although it can occur earlier or later. Unlike some vascular causes of cognitive decline, FTD is not primarily caused by blood vessel blockage, but conditions such as stroke can cause symptoms that overlap with dementia and should be evaluated.

Diagnosing FTD can be challenging because symptoms may overlap with psychiatric conditions, Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, normal pressure hydrocephalus, seizure disorders and vascular problems. There is no single test for FTD, so specialists use a combination of clinical history, neurological examination and testing.

Evaluation may include brain imaging, cognitive and neuropsychological testing, blood work, speech and language assessment, genetic counseling or testing when family history suggests inherited disease, and tests to rule out other conditions. In some cases, an electroencephalogram (EEG) may help evaluate seizures or other brain activity changes that can mimic cognitive symptoms.

There is currently no cure that stops or reverses FTD disorders, but treatment can help manage symptoms, support safety and improve quality of life. Care is often focused on understanding the specific symptoms, creating a structured routine and helping families plan for changing needs.

Treatment options may include:

• Medications to manage mood, behavior, sleep or movement symptoms
• Speech-language therapy for communication changes
• Occupational therapy for daily living strategies
• Physical therapy for balance or mobility issues
• Caregiver education

When symptoms overlap with other neurological conditions, Baptist Health specialists may coordinate care across Brain & Spine Care, rehabilitation, behavioral health and other services.

Some patients and families may also ask about research opportunities. Baptist Health offers access to research and clinical trials across many areas of care, and the care team can discuss whether an available study may be appropriate.

As FTD disorders progress, symptoms can affect communication, judgment, safety and independence. A person may become unable to manage finances, drive safely, take medications correctly or recognize risky situations. Language changes may make it harder to express pain, hunger, fear or medical concerns.

Possible complications include falls, swallowing problems, weight changes, infections, caregiver stress and the need for increasing supervision. Movement symptoms may also increase the risk of injury. Because sudden neurological changes can indicate an emergency condition such as stroke, families should seek immediate care when symptoms appear abruptly or are unlike the person’s usual pattern.

There is no proven way to prevent FTD disorders. However, early evaluation can help families understand the diagnosis, prepare for future care needs and address treatable conditions that may worsen thinking, mood or function.

Helpful steps may include reviewing medications, managing sleep, staying physically and socially active as tolerated, addressing hearing or vision problems, reducing fall risks and creating legal, financial and caregiving plans early. For families with a strong history of FTD or related neurological disease, genetic counseling may help clarify inherited risk.

If you or someone you love is experiencing changes in behavior, language, judgment, personality or daily functioning, schedule an evaluation with a neurology specialist. Early diagnosis can help clarify the cause of symptoms, identify treatable contributors and connect families with therapy, safety planning and long-term support.

To schedule a visit with a Baptist Health Brain & Spine Care provider, fill out an appointment request form or call 833-596-3876.