Frontotemporal dementia

Date Updated: 04/17/2026

Overview

Frontotemporal dementia (FTD), also known as frontotemporal lobar degeneration (FTLD), is an umbrella term for a group of brain diseases that mainly affect the frontal and temporal lobes of the brain. These areas of the brain are associated with personality, behavior and language.

In frontotemporal dementia, parts of these lobes shrink, known as atrophy. Symptoms of frontotemporal dementia depend on which part of the brain is affected. Some people with frontotemporal dementia have changes in their personalities. They may act in ways that seem socially inappropriate and may be impulsive or show less response to other people's feelings. Others lose the ability to use or understand language.

Frontotemporal dementia can be misdiagnosed as a mental health condition or as Alzheimer's disease. But FTD tends to occur at a younger age than does Alzheimer's disease. It often begins between the ages of 40 and 65, although it can occur later in life as well. FTD is the cause of dementia about 10% to 20% of the time.

Symptoms

Symptoms of frontotemporal dementia vary from person to person and usually get worse over time, often over years.

People with frontotemporal dementia often have groups of symptoms that occur together. They also may have more than one group of symptoms.

Early symptoms of frontotemporal dementia

These often involve changes in behavior, personality or language rather than memory. These symptoms may be mistaken for a mental health condition at first.

Early symptoms may include:

Changes in personality or behavior, such as acting in ways that seem out of character.
Reduced ability to understand or respond to other people's feelings.
Trouble planning, organizing or making decisions.
Repeating words or actions.
Changes in speech or language, such as trouble finding the right word.
Lack of interest, also called apathy.

Behavioral changes in frontotemporal dementia

The most common symptoms of frontotemporal dementia involve extreme changes in behavior and personality. These include:

Behavior that seems socially inappropriate or out of character.
Reduced ability to understand or respond to other people's feelings, a lack of empathy.
Lack of judgment.
Loss of inhibition.
Lack of interest, also known as apathy. Apathy can be mistaken for depression.
Compulsive behaviors such as tapping, clapping, or smacking lips over and over.
Changes in eating habits. People with FTD may overeat or prefer sweets and carbohydrates.
Eating things that are not food.
Repeatedly placing objects in the mouth.

Speech and language symptoms

Some subtypes of frontotemporal dementia lead to changes in language ability or loss of speech. Subtypes include primary progressive aphasia (PPA), including the semantic variant and the nonfluent or agrammatic variant.

These conditions can cause:

Increasing trouble using and understanding written and spoken language. People with FTD may not be able to find the right word to use in speech.
Trouble naming things. People with FTD may replace a specific word with a more general word, such as using "it" for pen.
Not understanding the meaning of words.
Hesitant speech that may use short, simple sentences.
Making mistakes in sentence building.

Primary progressive apraxia of speech is a brain condition that mainly affects how speech is produced, which is distinct from an aphasia. People with the condition know exactly what they want to say, but the brain has increasing difficulty planning and coordinating the movements of the lips, tongue and jaw needed to speak. As a result, speech may sound slow, effortful, choppy or distorted, even though understanding, reading and thinking may not be affected early on.

Movement symptoms

Rare subtypes of frontotemporal dementia cause movements similar to those seen in Parkinson's disease or amyotrophic lateral sclerosis (ALS).

Movement symptoms may include:

Tremor.
Rigidity.
Muscle spasms or twitches.
Poor coordination.
Trouble swallowing.
Muscle weakness.
Laughing or crying at times that don't match the situation.
Falls or trouble walking.

Frontotemporal dementia versus Alzheimer's disease dementia

Frontotemporal dementia and Alzheimer's disease are both types of dementia, but they affect the brain in different ways.

Frontotemporal dementia often begins at a younger age, usually between ages 40 and 65. Alzheimer's disease is more common in older adults.

Memory loss may not be an early symptom. In Alzheimer's disease, memory loss is often one of the first symptoms.

Frontotemporal dementia is sometimes mistaken for a mental health condition or Alzheimer's disease, especially in early stages.

Sometimes the clinical features of frontotemporal dementia and Alzheimer's disease overlap and can lead to a hard time diagnosing the condition.

Causes

In frontotemporal dementia, the frontal and temporal lobes of the brain shrink and certain substances build up. What causes these changes is usually not known. In some types of frontotemporal dementia, proteins such as tau or TDP-43 build up in the brain and damage nerve cells.

Is frontotemporal dementia hereditary?

Frontotemporal dementia can run in families. Some inherited gene changes are linked to certain types of the condition.

But many people with frontotemporal dementia have no known family history of the disease.

Researchers have confirmed that some of the same gene changes also are seen in amyotrophic lateral sclerosis (ALS). More research is being done to understand the connection between the conditions.

Risk factors

Your risk of developing frontotemporal dementia is higher if you have a family history of dementia. Some inherited gene changes are linked to frontotemporal dementia. In many people, the exact cause isn't known.

Diagnosis

Diagnosing frontotemporal dementia can be challenging, and there's no single test for it. Healthcare professionals consider your symptoms and rule out other possible causes. FTD can be hard to diagnose early because symptoms of frontotemporal dementia often overlap with those of other conditions. Your care team may recommend the following tests.

Blood tests

To help rule out other conditions, such as liver or kidney disease, you may need blood tests. Blood tests for Alzheimer's disease also may be considered if there is diagnostic uncertainty between conditions.

Sleep study

Some symptoms of obstructive sleep apnea can be similar to those of frontotemporal dementia. These symptoms can include changes in memory, thinking and behavior. You may need a sleep study if you experience loud snoring and pauses in breathing while you sleep. A sleep study can help rule out obstructive sleep apnea as a cause of your symptoms.

Neuropsychological testing

Healthcare professionals may test your thinking and memory skills. This type of testing can help identify the type of dementia, especially in early stages. It also can help distinguish FTD from other causes of dementia.

Brain scans

Images of the brain can reveal visible conditions that may be causing symptoms. These may include clots, bleeding or tumors.

Magnetic resonance imaging (MRI). An MRI machine uses radio waves and a strong magnetic field to produce detailed images of the brain. An MRI can show changes in the shape or size of the frontal or temporal lobes.
Fluorodeoxyglucose positron emission tracer (FDG-PET) scan. This test uses a low-level radioactive tracer that's injected into the blood. The tracer can help show how the brain uses sugar called glucose. Areas of low metabolism can show where changes have occurred in the brain and can help doctors diagnose the type of dementia.
Amyloid PET scan. This test uses a radioactive tracer that's injected into the blood to show the amyloid protein in the brain, which is one of the hallmark proteins of Alzheimer's disease. This test may be considered if there is diagnostic uncertainty after a thorough clinical evaluation.

Researchers are studying ways to make it easier to diagnose frontotemporal dementia. One approach includes biomarkers. Biomarkers are substances that can be measured to help diagnose a disease.

Treatment

There's no cure for frontotemporal dementia. Treatment focuses on managing symptoms. Medicines used to treat or slow Alzheimer's disease don't seem to help people with frontotemporal dementia. Some Alzheimer's medicines can even make FTD symptoms worse. But other medicines and speech therapy can help manage symptoms.

Medications

These medicines may help manage behavioral symptoms of frontotemporal dementia.

Antidepressants. Some types of antidepressants, such as trazodone, may reduce behavioral symptoms. Selective serotonin reuptake inhibitors (SSRIs) also are effective for some people. They include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Brisdelle) or sertraline (Zoloft).
Antipsychotics. Antipsychotic medicines, such as olanzapine (Zyprexa) or quetiapine (Seroquel), are sometimes used to treat behavioral symptoms of FTD. But these medicines must be used with caution in people with dementia. They can have serious side effects, including an increased risk of death.

Therapy

People with frontotemporal dementia who have trouble with language may benefit from speech therapy. Speech therapy can help people use communication tools and find other ways to communicate.

Lifestyle and home remedies

Living with frontotemporal dementia may grow more challenging over time, and many people need support from caregivers. Caregivers can help you with daily activities. They can help keep you safe, provide transportation and help with finances. Your healthcare professional can tell you when you may need to stop driving or let someone you trust take over your finances.

It's also important to get regular cardiovascular exercise. It may help improve your mood and thinking skills.

At home, it may be helpful to make adjustments so that daily living tasks are easier and you reduce the chance of injuries. For example, remove rugs to reduce falls. Or raise toilets to make it easier to use the bathroom.

Caregivers may be able to help people with frontotemporal dementia manage behavioral symptoms. Ask your loved one's healthcare professional about resources that provide training in caring for someone with dementia.

Keeping a log of behavioral symptoms may help you pinpoint things in the environment that trigger symptoms. Taking these steps also may help:

Skip events or activities that trigger behaviors that may be challenging.
Remove things from the environment that may trigger symptoms.
Maintain a calm environment.
Provide structured routines.
Simplify daily tasks.
Distract and redirect attention from behaviors that could be unsafe or disruptive.

Coping and support

If you've been diagnosed with frontotemporal dementia, receiving support, care and compassion from people you trust can be invaluable.

Through your healthcare professional or the internet, find a support group for people with frontotemporal dementia. A support group can provide information tailored for your needs. It also allows you to share your experiences and feelings.

For caregivers and care partners of people with frontotemporal dementia

Caring for someone with frontotemporal dementia can be challenging because FTD can cause extreme personality changes and behavioral symptoms. It may be helpful to educate others about behavioral symptoms and what they can expect when spending time with the person with FTD.

Caregivers and the spouses, partners or other relatives who care for people with dementia, known as care partners, need assistance. They might find help from family members, friends and support groups. Or they may use respite care provided by adult care centers or home healthcare agencies.

It's important for caregivers and care partners to take care of their health, exercise, eat a healthy diet and manage their stress. Participating in hobbies outside the home may help ease some stress.

When a person with frontotemporal dementia requires 24-hour care, most families turn to nursing homes. Plans made ahead of time will make this transition easier and may allow the person to be involved in the decision-making process.

Preparing for an appointment

People with frontotemporal dementia often don't recognize that they have symptoms. Family members usually notice changes and arrange for an appointment with a healthcare professional.

Your healthcare professional may refer you to a doctor trained in nervous system conditions, known as a neurologist. Or you may be referred to a doctor trained in mental health conditions, known as a psychologist.

What you can do

You may not be aware of all your symptoms, so it's a good idea to take a family member or close friend along with you to your appointment. You also may want to take a written list that includes:

Detailed descriptions of your symptoms.
Medical conditions you've had in the past.
The medical conditions of your parents or siblings.
All the medicines and dietary supplements you take.
Questions you want to ask your healthcare professional.

What to expect from your doctor

In addition to a physical exam, your healthcare professional checks your neurological health. This is done by testing things such as your balance, muscle tone and strength. You also may have a brief mental status evaluation to check your memory and thinking skills.