What is frontotemporal dementia? | CTV News

After taking a break from acting in March 2022 due to a speech disorder called aphasia, Bruce Willis, 67, has since been diagnosed with frontotemporal dementia, his family has announced. on Thursday.

“Since we announced Bruce’s diagnosis of aphasia in the spring of 2022, Bruce’s condition has progressed,” the Willis family noted in a statement. “Unfortunately, communication challenges are just one symptom of the illness Bruce faces. While this is painful, it’s a relief to finally have a clear diagnosis.”

Frontotemporal dementia, or FTD, is a group of disorders caused by the accumulation of tau and other brain cell-damaging proteins in the frontal lobes of the brain (behind the forehead) or the temporal lobes (behind the ears). your). According to Alzheimer’s Research UK, the condition usually occurs between the ages of 45 and 64.

“Most common in people under the age of 60, FTD can cause challenges with communication, as well as changes in a person’s behavior, personality, or movement,” according to a statement from Forehead Degeneration Association.

According to the National Institute on Aging, people with FTD typically live six to eight years with the condition. Between 10% and 30% of FTD cases are genetic. Aside from genetics, no other risk factors are known, although researchers are looking into what role thyroid and insulin may play in the onset of the disease.


Henry Paulson, a professor of neurology and director of the Michigan Alzheimer’s Disease Center at the University of Michigan, said that because his symptoms were starting to be difficult to tell, Bruce Willis would be classified as having a type of FTD called schizophrenia. primary progressive aphasia.

“Aphasia really means problems with language, and that can vary from having trouble finding words to understanding what people say,” says Paulson. caused by a brain tumor, stroke, or advanced neurodegenerative conditions.”

He added: “Because his diagnosis was frontotemporal dementia, Mr Willis clearly had a progressive neurodegenerative disease, as opposed to a stroke or tumor or some other lesion. on the brain”.

There are two other types of FTDs. The behavioral variant of frontotemporal dementia, or bvFTD, is characterized by changes in executive functioning, thinking, and planning.

Another type affects motor neurons and can present through an inability to swallow, muscle stiffness, and difficulty using the hand or arm to “perform a movement in defiance of normal strength, such as difficulty closing buttons or operating small appliances,” according to the National Institute on Aging.


At first, it can be difficult to know exactly what type of FTD a person has – or even whether it is FTD – because the symptoms and the order in which they appear can vary from person to person. different and depends on which part of the forehead. or the temporal lobe is affected.

In behavioral FTD, people rarely have problems with memory. Instead, they struggle to plan and organize their thoughts and have trouble setting priorities, according to the National Institute on Aging. They may repeat the same activities or words over and over, become disinterested in life, and act impulsively — saying inappropriate words or doing things that others might consider embarrassing.

In primary progressive aphasia, or PPA, the person may have difficulty speaking or understanding words or may stammer. Over time, they may fail to recognize familiar faces and objects. Some may become mute.

“PPAs can start to have trouble simply finding words, so people start using simpler words or more generic words for things they can’t remember well,” says Paulson.

He said: “Now that also comes in the territory of aging, but when language is becoming more difficult on a daily basis or comprehension is going downhill, that is a sign that someone should see a doctor. doctor for evaluation”.

Motor neuron FTD disorders may not affect memory, cognition, language, or behavior, especially at first. Early signs may include an inability to control movement or problems with balance and walking. A hallmark of one of these disorders, progressive supranuclear palsy, is difficulty looking down or making other eye movements.

HOW IS FTD Diagnosed?

To diagnose an FTD disorder, a neurologist will conduct a careful clinical examination, combined with psychological testing designed to assess cognitive skills, says Paulson.

“Brain magnetic resonance imaging can tell us if certain parts of the brain are shrinking or showing signs of atrophy. We’ll do some blood tests to make sure we don’t miss a single thing. There are some treatable causes of cognitive decline like thyroid disease or vitamin B12 deficiency,” he says.

“And sometimes, we’ll also take pictures of brain metabolism,” says Paulson. “It’s Positron emission tomography or PET imaging, and that can tell us which part of the frontal or temporal lobes is involved.”


Unlike Alzheimer’s disease, there is no current treatment to slow the progression of FTD. Health professionals can try to improve a patient’s quality of life by prescribing medication to reduce agitation, irritability, or depression.

A speech-language pathologist can help identify the best strategies and tools for FTD patients who are struggling with language skills. Physical therapy or occupational therapy, directed by a doctor who specializes in these disorders, can help reduce motor symptoms.

“It’s really important for people with progressive dementia like FTD to continue to eat healthy, exercise regularly, and stay connected with people. Those activities are not drugs. , they don’t cure the disease, but they can help your brain work as well as it can,” says Paulson.

As the disease progresses, patients can continue to lead active, satisfied lives, adapting their symptoms in an inspiring way, he added.

“I’ve seen patients who are completely speechless but they still go out, get their cameras, and take beautiful pictures of the life they’re living. They can’t tell me in words, but they have can tell me with pictures,” Paulson said.

“I tell all my patients, ‘Don’t let this disease control you. You own it,'” he added. “Sure, you’ve lost some skills because of the disease you have, but you still have a lot of skills and you work with the skills that you have.”

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