Behavioral Variant Frontotemporal Dementia

Behavioral variant frontotemporal dementia is the most common type of frontotemporal degeneration.  It is sometimes referred to as Pick’s disease, but that term is more accurately reserved for a particular pathology diagnosed at an autopsy.  The disease most commonly affects people younger than 65 years old but can present later in life as well. The disease is progressive and shortens lifespan.

Behavioral variant frontotemporal dementia causes changes in personality and behavior as its early signs. A person may become less interested in their usual hobbies and activities and have a decline in their motivation and goal-directed behavior (apathy). They may make rude or inappropriate comments and display a loss of empathy, uncharacteristic of their usual personality. The person may not “feel” like the person they used to be, and lack insight into these changes, both of which can be especially distressing for caregivers. Cognitively, executive function is more likely to be affected than memory initially, resulting in problems with planning, organizing, or multitasking. Dietary changes may occur, with a person developing a new tendency for particular foods, or new cravings for sweets or carbohydrates.

There is no cure for behavioral variant frontotemporal dementia. Given the prominent psychiatric changes, sometimes a person with behavioral variant frontotemporal dementia is mistakenly thought to have depression or bipolar disorder, and the dementia goes unrecognized. A comprehensive evaluation can clarify whether a person is suffering from a primary psychiatric condition or behavioral variant frontotemporal dementia. This is important since the course of each condition is so different. It is also important to distinguish between behavioral variant frontotemporal dementia and Alzheimer’s disease, which can sometimes mimic each other, because some medications used to treat Alzheimer’s disease can cause worse symptoms in behavioral variant frontotemporal dementia.

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