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Frontotemporal dementia
Expert reviewers, Dr Daniel Edward Anderson, Psychiatrist, Dr Naveen Puri, Bupa Clinics GP and Lead Physician, and Adrian Raby, General Practitioner
Next review due, January 2025
Frontotemporal dementia (FTD) is a type of dementia – a condition affecting your brain. It causes changes in behaviour, personality, speech and language. It’s a common type of dementia in people who develop dementia at a younger age (under 65).
What is frontotemporal dementia?
The term ‘dementia’ refers to a set of symptoms that can affect your memory and behaviour, and how you think and communicate. There are lots of different types of dementia. Frontotemporal dementia (FTD) is caused by damage to particular areas of your brain called the frontal and temporal lobes. These are the areas generally associated with personality, behaviour and language.
FTD accounts for about one in 50 cases of dementia. But it’s one of the commonest causes of dementia in people under 65. It most often first starts in people in their 50s and 60s, although it can develop in younger and older people too.
FTD affects people in different ways. Like other types of dementia, the condition gradually gets worse over time. But how quickly this happens is different for different people.
Symptoms of frontotemporal dementia
There are three main types of frontotemporal dementia (FTD). These are grouped by the type of symptoms seen when the condition first develops.
Behavioural variant frontotemporal dementia
This is the most common type of FTD. It’s sometimes known as Pick’s disease. With this type of dementia, changes in behaviour and personality are the main early symptoms. Typical symptoms include:
- behaving inappropriately in social situations –for example, saying things that are rude or tactless, or being aggressive
- losing motivation to do things that were previously enjoyed
- becoming less concerned for other people and losing the ability to understand other people’s feelings
- difficulty planning, organising and making decisions
- showing repetitive behaviour, having rituals and becoming obsessive about following routines
- developing eating fads, overeating or showing an increasing liking for sweet or fatty foods
Sometimes, people also have speech symptoms such as repeating what others say to them or stopping talking altogether.
Primary progressive non-fluent aphasia
In this type of FTD, people gradually lose the ability to speak fluently. Common symptoms include:
- speech becoming slow and hesitant
- making errors with grammar and order of words in speech
- missing out words or saying the opposite of what is meant
- finding it difficult to follow long or complex sentences even though the individual words are understood
- losing the ability to read and write
- stuttering
- having difficulty repeating words or sentences back to you
As the condition worsens, someone with progressive non-fluent aphasia may stop talking altogether.
Semantic dementia
People with this type of FTD start to forget the meanings of words. Unlike progressive non-fluent aphasia, they can still speak fluently. Symptoms include:
- asking what common or familiar words mean
- difficulty remembering what things are called or what words to use
- not recognising familiar faces or objects
Someone with this type will often have changes in behaviour such as becoming obsessed with routines.
Symptoms affecting movement
A few people with FTD also develop conditions that cause movement difficulties. One example is motor neurone disease (MND) which has symptoms such as muscle twitching, weakness and stiffness.
Some people may also develop symptoms that are similar to those in Parkinson’s disease – for example, tremors and slow movements.
Contact your GP if you’ve noticed changes in memory or behaviour, speech or language in yourself or a loved one.
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Help when you need itHow frontotemporal dementia progresses
Like other types of dementia, frontotemporal dementia (FTD) gradually gets worse over time. But how quickly it progresses varies from person to person and depends on several factors. It tends to develop faster in people who have motor neurone disease (MND) alongside the FTD.
As the condition progresses, people with FTD may develop more problems with memory, behaviour and understanding. They will also develop symptoms associated with the other types of FTD. For instance, people with the behavioural variant go on to develop language problems. Those with semantic or aphasic types, then develop changes in behaviour.
As time goes on, people with FTD will find it more difficult to manage day-to-day life. They’re likely to need help with more basic daily care such as washing and dressing. They may also lose bladder or bowel control (incontinence). Eventually, they’re likely to need full-time care.
Diagnosing frontotemporal dementia
Diagnosing dementia often takes time. It can be particularly difficult to diagnose frontotemporal dementia (FTD) because it’s not as common as other types of dementia. It can be hard to tell it apart from other problems and conditions that have similar symptoms.
A GP will want to talk to someone with possible symptoms of dementia about what changes they’ve noticed. If possible, the doctor will also want to talk to someone who knows the person well. This is because a close contact can tell the doctor about symptoms that the person may not be aware of. The GP may also ask about family history. This is important because it is helpful to the doctor to know if there have been other similar cases in the family.
The GP will usually also carry out a physical examination. They may ask for blood and urine samples to rule out other conditions. They may carry out a questionnaire to check for signs of dementia.
If a GP suspects dementia, they will refer the person to a specialist in dementia. The specialist may recommend some brain scans to confirm what type of dementia it is. These may include MRI and CT scans, and sometimes specialised brain scans called PET and SPECT scans.
Treatment for frontotemporal dementia
There isn’t any cure for frontotemporal dementia (FTD) or any way to slow it down. Instead, treatment aims to support the person with frontotemporal dementia and their carers. There is likely to be a team of health professionals managing the care for someone with frontotemporal dementia.
Supportive care for frontotemporal dementia
The healthcare team should advise on practical support available that may help with the day-to-day difficulties of living with FTD. They’ll offer advice and information to carers on how to support the person with dementia, as well as how to look after their own wellbeing. The team may recommend some of the following therapies and services:
- physiotherapy to help with any mobility difficulties
- occupational therapy to assess the home environment, transport and self-care needs
- speech and language therapy to help with communication problems and any difficulties swallowing
- behavioural therapies such as music and dance therapy, behaviour management and exercise therapy
- support for carers including information about support groups, counselling and respite care
Medicines
Doctors may prescribe medicines to help with symptoms of FTD. These may include:
- antipsychotic medicines to help with symptoms such as agitation, irritability and restlessness (your doctor will prescribe the lowest possible dose to avoid side-effects)
- antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) to help with behavioural symptoms
- other antidepressants to help with sleep problems
- medicines normally used for epilepsy, to help with excitability, restlessness and impulsive behaviour
If you’re caring for someone with dementia, it can be hard remembering what medicines they need to take and when. You may find it helpful to download our medicines planner for dementia carers (PDF, 0.8MB).
Taking lots of different medicines can sometimes increase confusion or memory problems. The doctor will regularly review medicines to make sure the person isn’t taking too many.
Medicines that are used to treat other forms of dementia such as Alzheimer’s disease do not help with FTD. Doctors won’t prescribe them for this form of dementia.
Causes of frontotemporal dementia
In frontotemporal dementia (FTD), certain areas of the brain become damaged. Proteins can build up inside brain cells (Pick’s bodies), and this may stop them from working properly.
It’s not clear exactly what causes these changes to happen in people with FTD But it may be partly down to genetic factors. Around three in 10 people with the condition have a strong family history. Sometimes, a single gene that causes FTD can be passed from a parent to a child. This is known as familial frontotemporal dementia. Other times, your genes may just increase your risk of developing FTD.
Outlook for frontotemporal dementia
It can be upsetting to read but being prepared for what to expect can help with planning ahead. Someone with frontotemporal dementia (FTD) is likely to need a lot of care as the condition progresses. How long someone may live varies from person to person and is difficult to predict. On average, people survive between 8 and 10 years following a diagnosis.
As time goes on, someone with FTD will become less able to look after themselves. They will usually need full-time care to meet their daily needs.
There is lots of support and advice available to help those affected by dementia. For details of organisations that can help, see our section: Other helpful websites.
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What are the early signs of frontotemporal dementia? What are the early signs of frontotemporal dementia?
The first signs of frontotemporal dementia tend to be changes in behaviour and personality or changes in speech and language. This will depend on the exact type you have. For more information, see our section on symptoms.
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Is frontotemporal dementia different from Alzheimer's? Is frontotemporal dementia different from Alzheimer's?
Frontotemporal dementia (FTD) is different from Alzheimer’s. FTD tends to cause fewer memory problems at first but causes more problems with behaviour and language in the early stages. It also tends to affect people at a younger age. Both conditions get gradually worse over time.
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Do people know they have frontotemporal dementia? Do people know they have frontotemporal dementia?
People with frontotemporal dementia might not always realise there’s anything wrong. Symptoms can come on slowly. Those closest to them may be more likely to notice symptoms first. For more information, see our section on symptoms.
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Other helpful websites Other helpful websites
- Alzheimer’s Society
0333 150 3456
www.alzheimers.org.uk - Dementia UK
0800 888 6678
www.dementiauk.org - Carers UK
0808 808 7777
www.carersuk.org - Age UK
0800 055 6112
www.ageuk.org.uk
Discover other helpful health information websites.
- Alzheimer’s Society
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Sources Sources
- Dementia. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised May 2021
- Frontotemporal dementia. Patient. patient.info, last edited 21 July 2021
- Frontotemporal dementia. BMJ Best Practice. bestpractice.bmj.com, last updated 17 September 2021
- Overview of cerebral function. MSD Manuals. msdmanuals.com, last full review/revision July 2020
- Frontotemporal dementia (FTD). Alzheimer's Society. www.alzheimers.org.uk, accessed 13 October 2021
- Frontotemporal dementia. Dementia UK. www.dementiauk.org, accessed 13 October 2021
- Dementia: assessment, management and support for people living with dementia and their carers. National Institute for Health and Care Excellence (NICE), published June 2018. www.nice.org.uk
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Author information Author information
Reviewed by Pippa Coulter, Freelance Health Editor, January 2022
Expert reviewers, Dr Daniel Edward Anderson, Psychiatrist, and Dr Naveen Puri, Bupa Clinics GP and Lead Physician, and Adrian Raby, General Practitioner
Next review due January 2025
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