Frontotemporal Dementia: Identification and Management

Leah Wilfong, MS, AGPCNP-BC; Nancy E. Edwards, PhD, ANP-BC; Karen S. Yehle, PhD, FAHA; Karla Ross, MSN, ANP


Journal for Nurse Practitioners. 2016;12(4):277-282. 

In This Article

Abstract and Introduction


Dementia is a disease primarily affecting older adults in their ability to carry out daily activities. Frontotemporal dementia (FTD), a leading cause of early-onset dementia, can present in the fourth and fifth decade by progressive changes in personality, affect, and behavior. The atypical presentation of FTD may resemble a midlife crisis, depression, schizophrenia, or a traumatic brain injury among its causes. The etiology of FTD is unknown, although genetic links have been suggested, thus treatment focuses on behavioral and symptom management. Early diagnosis of FTD is needed to better support the emotional and financial burdens of family and caregivers.


Dementia is a neurodegenerative disease presenting as a moderate to severe decline in cognition with the potential to hinder daily functioning.[1] The leading cause of dementia is Alzheimer's disease (AD), followed by dementia with Lewy body and frontotemporal dementia (FTD).[2] FTD represents about 10% of all diagnosed dementia cases, and is a leading cause of early-onset dementia.[3] The purpose of this article is to improve early diagnosis and management of FTD by increasing awareness, providing education to support primary care providers.

FTD is often mistaken for AD (Table 1), and has been diagnosed as schizophrenia or bipolar affective disorder due to its presentation early in life.[4] AD presents primarily as short-term memory or language loss displayed as forgetfulness, problems finding the right words, difficulty identifying familiar objects, and inability to complete routine tasks.[5] FTD presents with changes in affect, personality, and social conduct, often sparing memory loss in early stages. This is often noted as apathy, antisocial behavior, loss of inhibition, and lack of insight.[2]

Early diagnosis of FTD by clinicians is imperative. Life expectancy from the initial onset of symptoms averages 6.6–9 years, but only 3–4 years from time of diagnosis.[6] The average age of diagnosis is 57 years old, roughly 13 years earlier than the average for AD.[3]