What is Frontotemporal dementia (FTD)?

In light of the actor Bruce’s Willis’ recent family statement, ‘For Men To Talk’ wanted to understand what ‘Frontotemporal dementia (FTD)’ is.

The statement reads: “As a family, we wanted to take this opportunity to thank you all for the outpouring of love and compassion for Bruce over the past ten months. Your generosity of spirit has been overwhelming, and we are tremendously grateful for it. For your kindness, and because we know you love Bruce as much as we do, we wanted to give you an update.”

“Since we announced Bruce’s diagnosis of aphasia in spring 2022, Bruce’s condition has progressed and we now have a more specific diagnosis: frontotemporal dementia (known as FTD). Unfortunately, challenges with communication are just one symptom of the disease Bruce faces. While this is painful, it is a relief to finally have a clear diagnosis.” 

Bruce was originally diagnosed with aphasia, which is a neurological disorder that affects a person’s ability to understand and use language. It is typically caused by damage to the language centres of the brain, which are typically located in the left hemisphere of the brain.

Aphasia can affect various aspects of language, including speaking, listening, reading and writing. People with aphasia may have difficulty finding the right words, forming sentences, understanding spoken or written language, or using appropriate grammar.

However, this has now been re-diagnosed as Frontotemporal dementia (FTD). Frontotemporal dementia (FTD) is a group of disorders that affect the frontal and temporal lobes of the brain, leading to changes in behaviour, personality, language and movement. FTD is often misdiagnosed as a psychiatric disorder, as the symptoms can initially resemble those of depression, anxiety, bipolar disorder or schizophrenia. However, FTD is a progressive and irreversible brain disease that requires specialised diagnosis and care.

In the United Kingdom, an estimated 16,000 people have FTD, with a prevalence of around 15 cases per 100,000 people. FTD is more common in people aged 45 to 65, and affects men and women equally. The most common types of FTD are behavioral variant FTD (bvFTD), semantic dementia and progressive non-fluent aphasia.

The symptoms of bvFTD include changes in social behaviour, emotional regulation, judgment, decision-making, empathy and self-awareness. People with bvFTD may become socially inappropriate, impulsive, disinhibited, apathetic or compulsive. They may also experience mood swings, anxiety or paranoia. Semantic dementia affects language comprehension and memory, leading to difficulty in finding words, understanding meanings and recognising faces and objects. Progressive non-fluent aphasia affects language production, leading to difficulty in speaking, writing and understanding grammar and syntax.

The diagnosis of FTD requires a thorough neurological and neuropsychological evaluation, including brain imaging, cognitive testing and psychiatric assessment. The diagnosis may take several months or years as FTD can be difficult to distinguish from other brain disorders and psychiatric conditions. However, early diagnosis is crucial for effective treatment and support.

The treatment of FTD is mainly supportive, as there is no cure for the disease. The goals of treatment are to manage the symptoms, maintain the quality of life and provide emotional and practical support for the person and their family. Medications such as antidepressants, antipsychotics and mood stabilisers may be prescribed to alleviate the behavioural and psychological symptoms of FTD. However, these medications have limited efficacy and may have side effects.

Mental health is an important aspect of FTD, as the disease can affect not only the person’s cognitive and physical functioning, but also their emotional and social well-being. People with FTD may experience feelings of isolation, shame or confusion about their changing behaviour and identity. They may also feel stigmatised or misunderstood by their family, friends and society. Caregivers of people with FTD may also experience stress, depression, or burnout from the demands of caregiving.

Therefore, mental health support is essential for people with FTD and their families. This may include counseling, psychotherapy, support groups or respite care. Mental health professionals can help people with FTD and their families to cope with the emotional and practical challenges of the disease and to find meaning and purpose in their lives. They can also educate the public about FTD and reduce the stigma associated with the disease, which is what the Willis family are continuing to do.

The best wishes from everyone at ‘For Men To Talk’ go out to Bruce, his family and friends.