Frontotemporal Dementia Explained

Last spring, movie star Bruce Willis’ family announced that he was “stepping away” from his successful acting career due to complications with a neurological disorder called aphasia, which can cause challenges with speech and writing abilities.

Now, the iconic actor’s family has revealed that Willis’ condition has progressed to a frontotemporal dementia diagnosis, which can include aphasia.

His family stated, "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."

We wish Bruce Willis and his family all the best as he continues to receive the care and support he needs. We’re here to educate you on what frontotemporal dementia is, including signs and symptoms, diagnosis and treatments, and how it differs from Alzheimer’s disease and other forms of dementia.

What is Frontotemporal Dementia?

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

According to the Alzheimer’s Association, frontotemporal dementia is one of several types of dementia and causes nerve damage in the frontal and temporal lobes, which leads to a loss of function in those areas.

There are different kinds of frontotemporal dementia. Behavioral variant frontotemporal dementia causes nerve loss in the areas of the brain that control behavioral conduct, judgment and empathy.

Primary progressive aphasia deteriorates parts of the brain that control speaking, writing and comprehension. The onset of symptoms typically begins before age 65, but they can occur later. Willis is 67 years old.

How Does Frontotemporal Dementia Compare to Alzheimer's Disease and Other Forms of Dementia?

The type of dementia we tend to be most familiar with is Alzheimer’s disease. But there are actually other forms of dementia, including FTD. Diagnosis of FTD tends to happen between a person in their 40s and 60s, while Alzheimer's happens at a later age. Alzheimer's is also more closely tied to hallucinations, memory loss and issues with spatial orientation, such as getting lost.

Here are the types of dementia, briefly explained:

• Alzheimer's disease is the most common type of dementia, taking years to develop, and ultimately leading to the need for full-time assistance
• Frontotemporal dementia (FTD) is a loss of nerve cells in the front and side of the brain that leads to changes in your personality and behavior
• Lewy body dementia is caused by a buildup of protein deposits in nerve cells that affects thinking, memory, and motor control
• Mixed dementia is a combination of diagnoses, usually when Alzheimer's is mixed with vascular dementia or Lewy body dementia
• Vascular dementia affects your thinking skills and occurs after a heart attack or stroke

Diagnosing and Treating FTD

Doctors use brain imaging technology, such as MRIs, to diagnose frontotemporal dementia. The results are analyzed along with a patient's symptoms and medical history. There appears to be a genetic factor as about 30% of people with frontotemporal dementia inherit the illness. FTD has no known risk factors other than family history of dementia.

There are medications that can help relieve symptoms, but the disease eventually gets worse with time. Lifespan tends to average from 7 to 14 years from the time of diagnosis for a patient who has FTD.

FTD Signs and Symptoms

Signs and symptoms of frontotemporal dementia can be different from person to person. Symptoms tend to progressively worsen over years.

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

Behavioral changes, speech and language challenges and motor problems are some of the symptoms you might notice in someone with FTD.

Changes in Behavior Symptoms

• A decline in personal hygiene
• Apathy, which can be confused for depression
• Changes in eating habits, like overeating or a preference for sweets and carbohydrates
• Eating inedible objects
• Inappropriate social behavior
• Lack of judgment
• Loss of empathy and other interpersonal skills, such as having sensitivity to another's feelings
• Loss of inhibition
• Repetitive compulsive behavior, such as tapping, clapping or smacking lips
• Wanting to put things in their mouth

Speech and Language Symptoms

• Difficulty in using and understanding written and spoken language, such as having trouble finding the right word to use in speech or naming objects
• Hesitant speech that may sound truncated
• Making mistakes in sentence construction
• No longer knowing the meanings of words
• Trouble naming things, possibly replacing a specific word with a more general word such as "it" for “pencil”

Motor Symptoms

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

You are Still You, and We Treat the Whole You

Dementia touches your whole life, which is why we take a whole-person approach to caring for you or your loved one. Your care plan may include medications that slow down memory loss and ease sleeplessness, counselors to help with mood or personality changes and therapists to stimulate your brain with energizing exercises. If you need help at home, our social workers and home-care helpers can guide you, working to make each day as smooth as possible. We'll also help you to find a support group so that you can reap the healing benefits of community.

Our goal is a world without dementia. Our dedicated researchers are constantly working to uncover new medications and therapies for dementia. Some of this groundbreaking research has occurred at our own Neuroscience Institute in Florida, where we treat more neurological patients than any other hospital in the United States.

No matter what, you are still you and whole just as you are, even with dementia. We'll always be here to support you in body, mind and spirit.

Learn more about how we can help support you here.