Frontotemporal Dementia

Diagnosis

Frontotemporal dementia (FTD) is challenging to diagnose because its symptoms often overlap with other conditions, especially in the early stages. There is no single test that can confirm FTD. Healthcare professionals evaluate your symptoms, review your medical history, and rule out other possible causes before making a diagnosis.

You may need one or more of the following tests:

• Blood tests: These help exclude other possible causes, such as thyroid disorders, liver disease, or kidney disease.

• Sleep study: Since symptoms of obstructive sleep apnea, such as memory changes and behavioral shifts, can mimic FTD, a sleep study may be recommended to rule out sleep apnea.

• Neuropsychological testing: This involves assessing reasoning, judgment, language, and memory. It helps determine the type of dementia and distinguish FTD from other neurodegenerative diseases.

• Brain scans: Imaging tests can identify structural or functional brain changes. Common scans include:

  • Magnetic resonance imaging (MRI), which provides detailed images of the brain and can show shrinkage in the frontal or temporal lobes.

  • Fluorodeoxyglucose positron emission tomography (FDG-PET) scan, which detects areas of low metabolism in the brain, indicating where damage has occurred.

Researchers are actively studying biomarkers that may make diagnosing frontotemporal dementia easier in the future. Biomarkers are measurable substances that can indicate the presence of a disease.

Treatment

There is currently no cure for frontotemporal dementia, and treatments that slow or stop Alzheimer’s disease have not proven effective for FTD. In some cases, Alzheimer’s medicines may even worsen symptoms. However, certain medications and therapies can help manage behavioral and language difficulties, improving daily function and quality of life.

Medications

• Antidepressants: Medications such as trazodone or selective serotonin reuptake inhibitors (SSRIs) — including citalopram, escitalopram, paroxetine, or sertraline — can help reduce behavioral symptoms and improve mood.

• Antipsychotics: In some cases, medicines like olanzapine or quetiapine may be used to manage severe behavioral changes. These must be prescribed cautiously, as they may cause serious side effects, including an increased risk of death in people with dementia.

Therapy

People with frontotemporal dementia who experience language problems can benefit from speech therapy. Speech therapists can teach strategies to improve communication and recommend assistive devices to help with everyday interactions.

While there is no cure yet, ongoing research continues to explore potential treatments that could one day slow or prevent the progression of FTD. Early diagnosis, supportive care, and symptom management remain key to maintaining quality of life.