Frontotemporal Dementia

Frontotemporal dementia (FTD) is an umbrella term for progressive neurodegenerative disorders that mainly damage frontal and temporal brain networks. Loss of neurons and atrophy in these regions disrupt executive function, social judgement, emotional regulation, language and, in some phenotypes, movement. Tau or TDP-43 protein abnormalities are common pathological findings, but a clinical presentation does not identify the protein abnormality by itself. Behavioural-variant FTD (bvFTD) commonly begins with behavioural or executive change; primary progressive aphasia begins with progressive language impairment. Memory and orientation may be relatively preserved early, so intact recall does not establish safe judgement or exclude FTD. FTD often affects adults in midlife. The Alzheimer Society of Canada estimates that FTD accounts for approximately 10% of dementia cases and is the most common dementia in people under age 60 years. The US National Institute on Aging reports that roughly 60% of people with FTD are 45 to 64 years old. These population figures support considering FTD in a younger adult with progressive behavioural or language change, but they are not diagnostic cut-offs. Most cases are not inherited; a family...