Difference between Alzheimers and frontotemporal dementia

Overview

Frontotemporal dementia is an umbrella term for a group of brain disorders that primarily affect the frontal and temporal lobes of the brain. These areas of the brain are generally associated with personality, behavior and language.

In frontotemporal dementia, portions of these lobes shrink (atrophy). Signs and symptoms vary, depending on which part of the brain is affected. Some people with frontotemporal dementia have dramatic changes in their personalities and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use language properly.

Frontotemporal dementia can be misdiagnosed as a psychiatric problem or as Alzheimer's disease. But frontotemporal dementia tends to occur at a younger age than does Alzheimer's disease. Frontotemporal dementia often begins between the ages of 40 and 65 but occurs later in life as well. FTD is the cause of approximately 10% to 20% of dementia cases.

Symptoms

Signs and symptoms of frontotemporal dementia can be different from one individual to the next. Signs and symptoms get progressively worse over time, usually over years.

Clusters of symptom types tend to occur together, and people may have more than one cluster of symptom types.

Behavioral changes

The most common signs of frontotemporal dementia involve extreme changes in behavior and personality. These include:

  • Increasingly inappropriate social behavior
  • Loss of empathy and other interpersonal skills, such as having sensitivity to another's feelings
  • Lack of judgment
  • Loss of inhibition
  • Lack of interest (apathy), which can be mistaken for depression
  • Repetitive compulsive behavior, such as tapping, clapping or smacking lips
  • A decline in personal hygiene
  • Changes in eating habits, usually overeating or developing a preference for sweets and carbohydrates
  • Eating inedible objects
  • Compulsively wanting to put things in the mouth

Speech and language problems

Some subtypes of frontotemporal dementia lead to language problems or impairment or loss of speech. Primary progressive aphasia, semantic dementia and progressive agrammatic (nonfluent) aphasia are all considered to be frontotemporal dementia.

Problems caused by these conditions include:

  • Increasing difficulty in using and understanding written and spoken language, such as having trouble finding the right word to use in speech or naming objects
  • Trouble naming things, possibly replacing a specific word with a more general word such as "it" for pen
  • No longer knowing word meanings
  • Having hesitant speech that may sound telegraphic
  • Making mistakes in sentence construction

Motor disorders

Rarer subtypes of frontotemporal dementia are characterized by problems with movement similar to those associated with Parkinson's disease or amyotrophic lateral sclerosis (ALS).

Motor-related problems may include:

  • Tremor
  • Rigidity
  • Muscle spasms or twitches
  • Poor coordination
  • Difficulty swallowing
  • Muscle weakness
  • Inappropriate laughing or crying
  • Falls or walking problems

Causes

In frontotemporal dementia, the frontal and temporal lobes of the brain shrink. In addition, certain substances accumulate in the brain. What causes these changes is usually unknown.

There are genetic mutations that have been linked to frontotemporal dementia. But more than half of the people who develop frontotemporal dementia have no family history of dementia.

Recently, researchers have confirmed shared genetics and molecular pathways between frontotemporal dementia and amyotrophic lateral sclerosis (ALS). More research needs to be done to understand the connection between these conditions, however.

Risk factors

Your risk of developing frontotemporal dementia is higher if you have a family history of dementia. There are no other known risk factors.

Nov. 16, 2021

What Is Dementia?

Dementia is the name for a group of brain disorders that make it hard to remember, think clearly, make decisions, or even control your emotions. Alzheimer’s disease is one of those disorders, but there are many different types and causes of dementia.

Dementia isn’t just about simple memory mishaps -- like forgetting someone’s name or where you parked. A person with dementia has a hard time with at least two of the following:

  • Memory
  • Communication and speech
  • Focus and concentration
  • Reasoning and judgment
  • Visual perception (can’t see the difference in colors or detect movement, or sees things that aren’t there)

Since some types of dementia share similar symptoms, it can be hard for a doctor to figure out which one you or your loved one has. Be sure to tell them about all symptoms, medication and alcohol use, and previous illnesses to help them make the right diagnosis.

Types of Dementia

Vascular dementia: This is the second most common type. About one in 10 people who have dementia have vascular dementia, which causes progressive damage to the brain due to blood vessel damage or blockages that lead to mini-strokes or brain bleeding. Doctors used to call it multi-infarct or post-stroke dementia.

Unlike Alzheimer’s disease, memory loss isn’t the typical first symptom. Instead, people with vascular dementia can have different signs, depending on the area of the brain that’s affected, such as problems with planning or judgment. The FDA hasn’t approved any drugs to treat this type of dementia, but you can do some things to keep your brain and blood vessels healthy and try to prevent future damage. These include exercising, keeping blood pressure and cholesterol levels under control, and not smoking.

Dementia with Lewy bodies: Lewy bodies are abnormal clumps of a protein called alpha-synuclein. They build up in your cortex, the part of your brain that handles learning and memory.

This type of dementia causes problems with attention and things like driving early on, along with sleeping issues, seeing things that aren’t there (hallucinations), and slowed, unbalanced movements, similar to Parkinson’s disease symptoms. Memory loss tends to show up later in the disease.

Mixed dementia: Sometimes, a person has brain changes caused by more than one type of dementia. This is called mixed dementia. For example, you may have blocked or damaged blood vessels in your brain (vascular dementia) and brain plaques and tangles (Alzheimer’s disease) at the same time.

Frontotemporal dementia (FTD): This form of dementia involves the loss of nerve cells in the front and side areas of your brain -- behind your forehead and ears. Personality and behavior changes and trouble with language are the main symptoms. Some people also have a hard time with writing and comprehension.

Symptoms usually show up around age 60 -- earlier than they usually start with Alzheimer’s disease. Types of frontotemporal dementia include behavioral variant FTD (bvFTD), primary progressive aphasia, Pick's disease, corticobasal degeneration, and progressive supranuclear palsy.

Creutzfeldt-Jakob disease (CJD): This rare form of dementia happens when a protein, called a prion, folds into an abnormal shape, and other proteins start to do the same. This damages brain cells and triggers a fast mental decline.

People with CJD also have mood changes, confusion, twitchy or jerky movements, and trouble walking. Sometimes, the disease is passed down through families, but it also can happen for no known reason. One type, called variant CJD (or mad cow disease, also known as bovine spongiform encephalopathy), has spread from cattle to people in certain situations.

Huntington's disease: This is caused by a problem with a gene you get from one of your parents. It affects the central part of your brain -- the area that helps you think, move, and show emotion.

Symptoms typically start between ages 30 and 50. Uncontrolled arm, leg, head, face, and upper body movements are the first signs. The brain changes also lead to problems with memory, concentration, judgment, reasoning, and planning. People with Huntington’s disease also have issues with depression, anger, and crankiness. There’s no known cure for it.

Normal pressure hydrocephalus: The Alzheimer’s Association includes this buildup of spinal fluid in the brain as a form of dementia. Symptoms include slowed thinking, problems with decision making, trouble concentrating, behavior changes, difficulty walking, and loss of bladder control. It typically strikes adults in their 60s or 70s. Surgery to put a shunt in your brain to get rid of extra fluid can help.

Alzheimer’s Disease (AD)

This is the most common type of dementia. About 60% to 80% of people who have dementia have Alzheimer’s. It’s a progressive condition, which means it gets worse over time, and it usually affects people over 65 years old. There’s currently no cure.

It happens when proteins (called plaques) and fibers (called tangles) build up in your brain and block nerve signals and destroy nerve cells. Memory loss may be mild at first, but symptoms get worse over time.

Common Alzheimer’s symptoms include:

  • Trouble remembering names, events, or conversations
  • Problems concentrating
  • Personality changes, like not caring about things you used to, mistrust of others, or aggression
  • Mood changes
  • Depression
  • Impaired judgment or decision making
  • Confusion

It gets more difficult to carry on a conversation or do everyday tasks. A doctor can’t say you have Alzheimer’s with absolute certainty, but there are things they can do to be fairly sure. They include testing your attention, memory, language, and vision, and looking at images of your brain. These images are taken with an MRI (magnetic resonance imaging) machine, which uses powerful magnets and radio waves to make detailed pictures.

Treating Alzheimer’s Disease vs. Other Types of Dementia

Neither Alzheimer’s nor most other types of dementia have a cure. Doctors focus treatments on managing symptoms and keeping the disease from getting worse.

Some of the treatments for dementia and Alzheimer’s overlap.

  • Cholinesterase inhibitors can help with memory loss in certain types of dementia and Alzheimer’s.
  • Glutamate inhibitors help with learning and memory in both dementia and Alzheimer’s.
  • Sleep medications may help with sleep changes.
  • Antidepressants can help with depression symptoms.
  • Antipsychotic medications may help with behavior changes.

Some types of dementia respond to treatment, depending on what is causing it. Your doctor may recommend:

  • Stopping the use of drugs and alcohol
  • Treating a B12 deficiency
  • Treating hydrocephalus (extra fluid on the brain)
  • Getting blood sugar under control

Is frontotemporal dementia Alzheimer's?

Frontotemporal dementia can be misdiagnosed as a psychiatric problem or as Alzheimer's disease. But frontotemporal dementia tends to occur at a younger age than does Alzheimer's disease.

Is early onset Alzheimer's and FTD the same thing?

Key differences between FTD and Alzheimer's Memory loss tends to be a more prominent symptom in early Alzheimer's than in early FTD, although advanced FTD often causes memory loss in addition to its more characteristic effects on behavior and language.

What is the main difference between dementia and Alzheimer's?

While dementia is a general term, Alzheimer's disease is a specific brain disease. It is marked by symptoms of dementia that gradually get worse over time. Alzheimer's disease first affects the part of the brain associated with learning, so early symptoms often include changes in memory, thinking and reasoning skills.

What are the 7 stages of frontotemporal dementia?

Eight phases of FTD.
Unexplained small things. ... .
Driving and work problems. ... .
Apathy. ... .
Trouble with swallowing. ... .
Behaviour. ... .
Trouble with balance and mobility. ... .
More physical symptoms. ... .
The final days..