Frontotemporal dementia, or FTD (also known as frontotemporal disorders or frontotemporal lobar degeneration), is one of the less common types of dementia. It often affects people at a younger age than Alzheimer’s disease. While Alzheimer’s usually begins with memory problems, FTD tends to start with changes in personality, behavior, or language. Because of this, it can sometimes be mistaken for a mental health or relationship issue before a neurological condition is recognized.
What Is Frontotemporal Dementia?
FTD is a group of brain disorders that happen when the nerve cells in the front and sides (frontal and temporal lobes) of the brain start to shrink and die. These areas are responsible for personality, judgment, language, and movement. As those cells are damaged, the person may act differently, have trouble communicating, or lose interest in things they once cared about.
There are a few subtypes of FTD:
- Behavioral variant FTD (bvFTD): Causes major changes in behavior, mood, and social interactions.
- Primary progressive aphasia (PPA): Affects the ability to speak, find words, or understand language.
- Movement-related types: Can cause stiffness, tremors, or balance issues similar to Parkinson’s disease.
What Causes FTD?
We don’t yet know exactly why FTD develops, but it’s linked to abnormal buildups of certain proteins (like tau or TDP-43) in the brain that damage brain cells. In about one third of people, the cause is genetic. In most cases, however, there’s no clear reason why it happens.
FTD typically appears between ages 45 and 65, though it can occur earlier or later. Although it is overall less common than Alzheimer’s disease, it is the most common cause of dementia in adults younger than age 60.
Common symptoms of FTD
Because FTD affects the parts of the brain that control behavior and language, symptoms can look very different from person to person. Some common symptoms include:
- Personality or behavior changes (acting impulsively, losing empathy, seeming withdrawn)
- Repetitive movements or speech
- Trouble speaking or understanding words
- Poor judgment or decision-making
- Difficulty with daily tasks like managing finances or hygiene
- Stiffness, slowed movement, or falls
Unlike typical Alzheimer’s disease, early FTD usually does not primarily cause memory loss.
Diagnosis and treatment
There is no single test used to diagnose FTD. Diagnosis often involves a combination of reviewing medical and family history, cognitive and behavioral assessments, brain imaging (MRI or CT) to look for changes in the frontal or temporal lobes, and genetic testing.
There is no cure yet for FTD, but there are ways to manage symptoms and improve quality of life. Treatment for FTD may include medications to help with mood or behavior changes, speech therapy to support communication, and occupational and physical therapy to help maintain independence.
Support for individuals and families
Support and planning make a big difference for both the person with FTD and their loved ones. Because this condition often begins when people are still working or raising families, it can be emotionally and financially stressful.
If you or someone you care about is showing sudden changes in personality, language, or movement, it’s important to speak with a healthcare professional. Early evaluation can help clarify what’s happening and open doors to supportive care and resources.
If your loved one is living with FTD, know that you are not alone. Isaac Health’s care team is here to help you, from diagnosis to care management and caregiver support. The Association for Frontotemporal Degeneration (AFTD) is another leading organization that provides education, support groups, and caregiver guides for people living with FTD and their families.