Symptoms

Frontotemporal dementia usually causes changes in behaviour or language problems at first.

These come on gradually and get worse slowly over time.

Eventually, most people will experience problems in both of these areas. Some people also develop physical problems and difficulties with their mental abilities.

Behaviour and personality changes

Many people with frontotemporal dementia develop a number of unusual behaviours they're not aware of.

These can include:

• being insensitive or rude
• acting impulsively or rashly 
• loss of inhibitions
• seeming subdued
• losing interest in people and things
• losing drive and motivation
• inability to empathise with others, seeming cold and selfish
• repetitive behaviours, such as humming, hand-rubbing and foot-tapping, or routines such as walking exactly the same route repetitively
• a change in food preferences, such as suddenly liking sweet foods, and poor table manners
• compulsive eating, alcohol drinking and/or smoking
• neglecting personal hygiene

As the condition progresses, people with frontotemporal dementia may become socially isolated and withdrawn.

Language problems

Some people experience problems with speech and language, including:

• using words incorrectly – for example, calling a sheep a dog
• loss of vocabulary
• repeating a limited number of phrases
• forgetting the meaning of common words
• slow, hesitant speech
• difficulty making the right sounds to say words
• getting words in the wrong order
• automatically repeating things other people have said

Some people gradually lose the ability to speak, and can eventually become completely mute.

Problems with mental abilities

Problems with thinking do not tend to occur in the early stages of frontotemporal dementia, but these often develop as the condition progresses.

These can include:

• difficulty working things out and needing to be told what to do
• poor planning, judgement and organisation
• becoming easily distracted
• thinking in a rigid and inflexible way
• losing the ability to understand abstract ideas
• difficulty recognising familiar people or objects
• memory difficulties, although this is not common early on

Physical problems

In the later stages, some people with frontotemporal dementia develop physical problems and difficulties with movement.

These can include:

• slow, stiff movements, similar to Parkinson's disease
• daily activities may be more difficult including eating and problems swallowing
• loss of bladder control
• loss of bowel control

Some people have frontotemporal dementia overlapping with other neurological (nerve and brain) problems, including:

• motor neurone disease – causes increasing weakness, usually with muscle wasting
• corticobasal degeneration – causes problems controlling limbs, loss of balance and co-ordination, slowness and reduced mobility
• progressive supranuclear palsy – causes problems with balance, movement, eye movements and swallowing

Getting medical advice

See a GP if you think you have early symptoms of dementia. If you're worried about someone else, encourage them to make an appointment with a GP and perhaps suggest you go with them.

The GP can do some simple checks to try to find out the cause of your symptoms, and may refer you to a specialist for further tests.

It's usually very helpful to have someone at the consultation who knows you well and can give the specialist another perspective on your symptoms.

Read more about:

• Getting a dementia diagnosis
• Tests used to diagnose dementia
• Advice if you're worried someone else could have dementia