Symptoms of frontotemporal dementia

The symptoms of frontotemporal dementia usually develop gradually and get increasingly worse over a number of years.

The early symptoms can varybetween different people with the condition, depending on which part of the brain is affected. Many people will initially have either behavioural or language problems.

As the condition progresses, most people experience problems in both of these areas, as well as additional physical problems and thinking difficulties. Eventually, the condition spreads to affect most brain functions.

These groups of symptoms are described below.

Behavioural and mood changes

In most cases, people with frontotemporal dementia display a number of unusual behaviours that they are not aware they have developed.

These can vary widely from person to person for example, some may be uninterested and seem to have no drive, while others may be impulsive andmore outgoing,with no inhibitions.

Typical signs are:

• inappropriate behaviour in public
• impulsivity
• loss of inhibitions
• overeating, a change in food preferences (such as suddenly liking sweet foods), poor table manners
• neglect of personal hygiene
• repetitive or obsessional behaviours, such as humming, hand-rubbing and foot-tapping, or complex routines such as walking exactly the sameroute repetitively
• seeming more selfish and unreasonable
• inability to empathise with others, seeming cold and uncaring
• irritabilityand aggression
• being tactless or rude
• being less or more outgoing than in the past
• being lethargic, lacking enthusiasm

As the disease progresses, people with frontotemporal dementia may become sociallyisolated and withdrawn.

Language problems

Manypeople withfrontotemporal dementia experience problems with speech and language.

Symptomscan include:

• using words incorrectly for example, calling a sheep a dog
• reduced vocabulary
• repeating a limited number of phrases
• more effortful or less articulate speech
• automatically repeating things other people have said
• reduced speech and conversation

Some people gradually lose the ability to speak, and can eventually become completely mute.

Problems with thinking

Many people withfrontotemporal dementia eventually lose the ability to think for themselves.

Symptoms can include:

• needing to be told what to do
• poor planning, judgementand organisation
• becoming easily distracted
• thinking in a rigid and inflexible way
• losing the ability to understand abstract ideas
• memory difficulties (although not common in the early stages)

Physical problems

In the later stages, many people with frontotemporal dementia may develop problems with movement. They may no longer initiate movements and may become rigid, similar to Parkinson's disease .

Some people may lose control of their bladder ( urinary incontinence ) and bowel ( bowel incontinence ).

In a few cases, frontotemporal dementia can occur with otherneurological (nerve andbrain)problems that cause additional physical symptoms, including:

• motor neurone disease whichcauses progressive weakness, usually with muscle wasting
• corticobasal degeneration which can causeproblems controlling certain limbs, loss of balance and co-ordination, slowness and reduced mobility
• progressive supranuclear palsy which cancause problems with balance, movement, eye movements and swallowing

Seeking medical advice

If you think you may have early symptoms of dementia, it's a good idea to see your GP. If you're worried about someone else, encourage them to make an appointment and perhaps suggest that you go along with them.

Symptoms of dementia can have a number of different causes. Your GPcan carry out some simple checks to try to find out what the cause may be, and they can refer you to a specialist for further tests if necessary.

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