Bruce Willis’ family announced that the actor has frontotemporal dementia, better known as FTD, a form of dementia that typically occurs when the number of nerve cells in the frontal and temporal lobes of the brain decreases . Mr Willis, 67, was previously diagnosed with aphasia, which prompted him to retire from acting. “FTD is a cruel disease that many of us have never heard of and it can happen to anyone,” the family wrote in a statement.
There are two main variants of FTD: primary progressive aphasia, which impairs a patient’s ability to communicate, and behavioral variant frontotemporal dementia, which manifests as personality and behavioral changes. “It hits the parts of the brain that make us most human,” said Dr. Bruce Miller, professor of neurology at the University of California, San Francisco.
Susan Dickinson, chief executive of the Association for Frontotemporal Degeneration, said FTD is the most common cause of dementia for people under the age of 60. There are about 50,000 people in the United States with a diagnosis of FTD, he said, though many experts consider that number a vast undercount because of how challenging it can be to diagnose. There is no blood test or single biomarker to diagnose the condition – instead doctors identify it based on symptoms and neuroimaging. On average, it takes patients more than three years to get an accurate diagnosis, Ms Dickinson said.
What are the first symptoms of frontotemporal dementia?
People with primary progressive aphasia may have difficulty speaking in complete sentences or may have difficulty understanding conversation. They may have difficulty writing or reading.
Assistant Professor of Neurology at Northwestern University Feinberg School of Medicine, Dr. Ian Grant states that people with the behavioral version of FTD may act out of character. Families will say that patients “feel like they’ve lost a little bit of their filter,” he said. Someone who is usually quiet and reserved, for example, may start spewing slurs, or commenting out loud in the presence of a stranger. The person may act apathetic, Dr. Miller said, losing motivation. Some may also display a lack of empathy for those around them.
People with FTD often struggle with organizational skills, failing to multitask or plan. Frontotemporal dementia can also manifest in excessive gambling or impulsive spending, said Dr. Joel Salinas, clinical assistant professor of neurology at NYU Langone Health.
Dr. Grant described the poor judgment and erratic behavior that can come with personality changes from FTD, such as drinking an entire bottle of maple syrup. “They may be craving instant gratification, without any real ability to put a stop to it,” he said.
Dr. Grant said that in some cases, these symptoms can lead to patients being misdiagnosed with a mental condition like bipolar disorder. There are some ways to differentiate between the psychiatric condition and FTD, though: Frontotemporal dementia usually affects people in their 50s and 60s, and it’s unusual, though not impossible, he said, for people that age. A new psychiatric development in without a previous history of mental health concerns.
In addition, a brain scan in a person with FTD may show atrophy or shrinkage in the front of the brain, whereas those with a mental illness would be less likely to show such changes.
What causes frontotemporal dementia?
Genetics are an important risk factor for FTD, but beyond that, doctors aren’t sure what causes the disease in most people, Dr. Miller said. However, there are things that even people with a family history of the disease can do to reduce their risk of developing dementia or slow the course of the disease, he said, including exercising, connecting with others and doing cognitive activities like reading. activities to be maintained. Crosswords, learning a new language or playing a musical instrument. But there is no evidence that any one activity can prevent FTD, Ms Dickinson said.
What are the treatment options for FTD?
Typically, patients with FTD will live for about five to seven years after they first display obvious symptoms, Dr. Grant said. There’s no cure — “but there’s a difference between not treating a disease and saying, ‘There’s nothing we can do,'” he said.
Occupational therapy can help patients who have difficulty communicating. Speech therapy may also be a means of helping these patients, Dr. Salinas said.
Therapists often work with families or loved ones of people with FTD to develop a care plan, which may include safety measures to ensure they cannot hurt themselves or their loved ones. Doctors can prescribe medications to help manage symptoms; Dr. Miller said some patients may be prescribed antidepressants to deal with mood or behavioral symptoms.
Ms Dickinson said patients often benefit from a stable, predictable routine. She said many patients, as well as family members, find comfort in support groups.
Doctors also work to make sure families are taking care of themselves. “The family often suffers as much as the patient,” Dr. Miller said.