Symptoms of Frontotemporal Dementia

More information from NW University Website, with notes as they pertained to our family http://www.brain.northwestern.edu/mdad/frontal.html

Symptoms of Frontotemporal Dementia

* Impairments in social skills- inappropriate or bizarre social behavior (e.g., eating with one's fingers in public, being overly familiar with strangers)- "loosening" of normal social restraints (e.g., using obscene language or making inappropriate sexual remarks) [My brother became more restrained in public, not wanting to talk or interact, whereas my sister became more flirtatious and extroverted]

*Change in activity level- apathy, withdrawal, loss of interest, lack of motivation, and initiative which may appear to be depression but the patient does not experience sad feelings.- in some instances there is an increase in purposeless activity (e.g., pacing, constant cleaning) or agitation. [This varied as the stages varied. Michael had no desire to do anything, just wanted to watch a couple shows on TV and Patsy would buy a scratch lotto ticket, coke and candy bar every day "because it was a good deal".]

* Decreased Judgment- impairments in financial decision- making (e.g., impulsive spending)- difficulty recognizing consequences of behavior- lack of appreciation for threats to safety (e.g., inviting strangers into home) [Michael was frugal, where Patsy would take out credit cards and spend to the limit. Michael had my mother pay for repairs to his home during a visit. Before his illness, he would never have allowed that. Patsy had to be bailed out financially several times by mom. She couldn't pay her rent because she had spent her money on scratch tickets or computer equipment.]

* Changes in personal habits- lack of concern over personal appearance- irresponsibility- compulsiveness (need to carry out repeated actions that are inappropriate or not relevant to the situation at hand. [Michael and Patsy both gained weight late into the disease. They couldn't cook or operate the kitchen equipment any longer. Michael stopped showering regularly. Both were paranoid about security, would check and double check making sure the blinds were closed and doors locked.]

* Alterations in personality and mood- increased irritability, decreased ability to tolerate frustration [Michael would get frustrated with mom when she was visiting. He would go behind her and make sure she was locking the doors, she‘d open the blinds, he‘d close them. One time he got very angry with her when she pinched his side when he was playing pool (she was playing), he whirled around with the cue in his hand like he was going to hit her (he didn‘t, but here was a man that was very gentle historically…scared mom to death. Patsy got so frustrated when she got a ticket one time and I was trying to help her handle the situation in the courtroom. She got angry with me when I was trying to tell her what to say, or suggested I handle it...she just yell and I backed off. When the time came, she just blubbered not saying anything of consequence and the judge I am sure wondered what in the heck she was even doing there.]

* Changes is one's customary emotional responsiveness- a lack of sympathy or compassion in someone who was typically responsive to others' distress- heightened emotionality in someone who was typically less emotionally responsive. [Both showed less interest in their grandchildren, were afraid to hold them or play with them. You could tell them something sad about another person and they might smile and walk away.]

* I am adding this one. Artistic abilities may excel. For years Patsy would paint, draw, work with clay etc. She created many beautiful pieces, but towards the end, her drawings became dark. Then she got where she couldn't draw at all. Michael was an excellent golfer, but towards the end couldn't make a 6' put. He also started to draw. He drew mostly flowers and mountains. The doctors tell us since our mother was artistic, that ability existed all along, they just never developed it. Once the brain started to atrophy, this section was working overtime to compensate....so they started to paint and draw.

Persons with this form of dementia may look like they have problems in almost all areas of mental function. This is because all mental activity requires attention, concentration and the ability to organize information, all of which are impaired in frontal lobe dementia. Careful testing, however, usually shows that most of the problems stem from a lack of persistence and increased inertia.