Dementia occurs in middle age
If you start to see changes in the way a loved one acts, speaks, or moves under age 60, you may not think dementia is the cause. Dementia is an inability to think, memory, and reason that severely affects your daily activities. It is more common in older people. But a group of dementias called vestibular disorders, or FTDs, occur most often in people aged 45 to 64.
“Many people with FTD begin to have symptoms early in life,” says Dr. Bradley Boeve, an FTD researcher at the Mayo Clinic.
FTDs are rare. It sometimes runs in families and can be inherited through a number geneThe pieces of DNA that you inherit from your parents determine characteristics, such as your risk of certain diseases.. But in most cases, the cause is not known.
People with FTD have an accumulation of certain proteins in brain cells called neurons. This damages the cells and eventually causes them to die. Symptoms depend on where the proteins cause brain damage.
The most common symptoms of FTD are changes in behavior and personality. But instead, some people with FTD may develop speech and language problems, known as aphasia. FTD can also cause motion problems. (See the Wise Choices box for more symptoms.)
FTD can be difficult to diagnose. “When symptoms do arise, it is very common that other disorders or life circumstances are suspected as the cause,” says Boeve. Causes may include substance use or certain mental health disorders, such as depression or psychosis.
“Symptoms can also tend to go up and down at first,” says Boeve. “Someone can act very odd, and then everything becomes normal for weeks or months.” But symptoms get worse and become more consistent over time.
Blood tests or imaging tests such as an MRI or PET scan can sometimes detect certain signs of FTD. “But some people with mild FTD can have normal results on many of these tests,” says Boeve. If FTD is suspected, talking to a healthcare provider experienced with FTD can help with the diagnosis.
People with FTD usually live six to eight years. There is no cure, but some symptoms can be controlled. Certain antidepressants may help some patients with mental health symptoms, such as lethargy, depressed mood, or irritability. “They can also help curb inappropriate behavior,” explains Boeve. Speech therapy is used for some types of aphasia. Physical therapy can help with some movement problems.
“But the mainstay of management is educating and empowering family members,” says Boeve. This includes learning how to keep a safe home environment, manage loved ones’ behavior, and prevent caregiver burnout.
Boeve’s team and other NIH-funded researchers are working to develop better tests and treatments for FTD. Recently, a study by Boeve and others found that exercise slows the progression of FTD in people with the genetic condition. “For people who are more physically active, their rate of decline is slower,” he said.
“We don’t have dramatic therapy yet,” Boeve added, “but we’ve learned a lot about FTD over the last three to five years so there’s real hope. In addition, there are a number of clinical trials currently underway or in development for people with FTD.”
