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Frontotemporal Dementia. Dr Rita Kronstorfer Old Age Psychiatry BCULHB. Why do we talk about FTD?. 3 rd most common dementia under 65 Recent study in Cambridgeshire: Age range 45–64 years 11.5 cases per 100,000 person-years, 3.5 FTD Poorly understood in general public

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frontotemporal dementia

Frontotemporal Dementia

Dr Rita Kronstorfer

Old Age Psychiatry

BCULHB

why do we talk about ftd
Why do we talk about FTD?
  • 3rd most common dementia under 65
  • Recent study in Cambridgeshire: Age range 45–64 years 11.5 cases per 100,000 person-years, 3.5 FTD
  • Poorly understood in general public
  • Challenge to patients, carers and professionals
variants of ftd pick complex
Variants of FTD / Pick Complex
  • Behavioural / frontal variant (classic Pick’s Disease)
  • Temporal Variants:Semantic Dementia - fluentPrimary Progressive Aphasia – non fluent
  • Progressive Supranuclear Palsy
  • Corticobasal Degeneration
  • FTD with Motoneuron Disease
symptoms frontal variant
Symptoms – Frontal variant
  • Disinhibition / inhibition
  • Elated mood / depression / flat mood
  • Agitation / apathy
  • Repetitive behaviour
  • Loss of social skills
  • Preference of sweet food
  • Utilisation behaviour
treatment
Treatment
  • Antidepressants
  • Neuroleptics
  • Acetylcholinesterase Inhibitors ?
  • Memantine ?
  • Trageting Tau- Pathology: Research
problems
Problems
  • Delay in diagnosis
  • Early Onset
  • Problems with communication
  • Lack of services skilled to meet needs
  • Sometimes progression can be rapid
  • Very variable course of illness
  • Sometimes mobility problems as well
carer stress
Carer Stress
  • Early personality change – not the person they know / love any more
  • Disinhibition and lack of social understanding cause distress / trouble with police
  • Lack of public knowledge around diagnosis
  • Difficulties recognizing symptoms as organic
  • Communication problems
genetics
Genetics
  • Seems higher than in Alzheimer’s disease
  • Some known mutations – explain around 5-10%
  • Higher frequency in certain areas
  • Sometimes Motoneuron disease and FTD in same family
  • Many cases are sporadic
summary
Summary
  • Frequent, but poorly understood illness
  • Diagnosis is very important to help patient/ family cope and get support
  • High carer stress
  • Symptomatic treatment available
  • Very variable disease course – Not one, but many illnesses!
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