Dementia: ‘Progressive coarsening of personality and social behaviour’ could be signs
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Frontotemporal dementia (FTD), a common cause of dementia, is a group of disorders that occur when nerve cells in the frontal and temporal lobes of the brain are lost. This causes the lobes to shrink. FTD can affect behaviour, personality, language, and movement.
Symptoms of FTD start gradually and progress steadily, and in some cases, rapidly.
They vary from person to person, depending on the areas of the brain involved.
Unusual or antisocial behaviour as well as loss of speech or language are usually the first symptoms.
In later stages, patients develop movement disorders such as unsteadiness, rigidity, slowness, twitches, muscle weakness or difficulty swallowing.
In a study with BMJ, early symptoms of frontotemporal dementia were further explored.
The study noted: “Early symptoms include progressive coarsening of personality, social behaviour, self-regulation (of emotions, drives, and behaviour), and language.
“Gross changes in social behaviour and language are often seen, including indifference to self-care and others’ needs, loss of speech and comprehension, loss of empathy, distractibility, impulsiveness, disinhibition, stereotyped behaviours and rigid routines, and compulsions.”
“FTDs typically appear in mid-life, with average age of onset between 45 and 65 years, and peak prevalence in the seventh decade,” added the research.
According to John Hopkins Medicine, early symptoms of frontotemporal dementia may include:
- Behaviour and/or dramatic personality changes, such as swearing, stealing, increased interest in sex, or a deterioration in personal hygiene habits
- Socially inappropriate, impulsive, or repetitive behaviours
- Impaired judgment
- Apathy
- Lack of empathy
- Decreased self awareness
- Loss of interest in normal daily activities
- Emotional withdrawal from others
- Loss of energy and motivation
- Inability to use or understand language; this may include difficulty naming objects, expressing words, or understanding the meanings of words
- Hesitation when speaking
- Less frequent speech
- Distractibility
- Trouble planning and organizing
- Frequent mood changes
- Agitation
- Increasing dependence.
There’s no single test for frontotemporal dementia, says the NHS.
According to the national health body, the following may be needed to make a diagnosis:
An assessment of symptoms – it’s normally helpful to have somebody who knows the person well to give an account of their symptoms, especially as someone with frontotemporal dementia may not be aware of changes in their behaviour
An assessment of mental abilities – this will usually involve a number of tasks and questions
Blood tests – to rule out conditions with similar symptoms
Brain scans – such as an MRI scan, a CT scan or a PET scan; these can detect signs of dementia and help identify which parts of the brain are most affected, or help rule out other problems with the brain
Lumbar puncture – to test the spinal fluid (fluid that surrounds and supports the brain and spine); this may be useful to rule out Alzheimer’s disease as the cause of symptoms.
Although some prominent risk factors, such as age, cannot be modified, others can.
According to Alzheimer’s Research UK, there are a number of lifestyle risk factors, many of which are similar to those for cardiovascular conditions.
These include smoking, unmanaged hypertension, diabetes and lack of education.
Other factors have been proposed, although currently the evidence base is less certain, including obesity, alcohol consumption, physical inactivity, sports-related head injuries and depression.
Air pollution has also been a focus of several studies on cognitive impairment and dementia risk.
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