Frontotemporal Dementia

A group of dementias that often strike in midlife and change personality, behavior or language before memory.

Last reviewed: October 2026

Frontotemporal dementia (FTD) is the name for a group of brain disorders that damage the frontal lobes (behind the forehead) and temporal lobes (behind the ears). These areas control personality, behavior, judgment, emotions and language. Unlike Alzheimer's, FTD often begins between ages 45 and 64, and memory may remain fairly intact early on. It is one of the most common causes of dementia in people under 65.

Main types

Behavioral variant FTD (bvFTD)

The most common form. Changes in personality and behavior come first, such as:

Acting impulsively or inappropriately in public; loss of manners
Apathy—losing interest in people, work or hobbies—which can be mistaken for depression
Loss of empathy and concern for others
Repetitive behaviors, hoarding, or rigid routines
Changes in eating: overeating, craving sweets, or putting non-food items in the mouth
Poor judgment, including risky spending or falling for scams
Lack of awareness that anything has changed

Primary progressive aphasia (PPA)

Language is affected first:

Semantic variant – losing the meaning of words and names of objects and people.
Nonfluent/agrammatic variant – speech becomes halting and effortful, with grammar errors.
(A third, logopenic variant is usually caused by Alzheimer's disease.)

Movement disorders

Some FTD-related conditions mainly affect movement—progressive supranuclear palsy (PSP) and corticobasal syndrome—and some people develop FTD together with ALS (motor neuron disease).

Causes and genetics

In FTD, nerve cells in the frontal and temporal lobes are lost, usually with abnormal buildups of the proteins tau or TDP-43. About a third of people with FTD have a family history of a similar disorder, and a meaningful share of cases are caused by inherited gene changes—most commonly in C9orf72, GRN or MAPT. Families with several affected members may benefit from genetic counseling.

Why diagnosis is often delayed

Because it strikes in midlife and starts with behavior or language, FTD is frequently mistaken for depression, bipolar disorder, a midlife crisis, relationship problems or stress. Families commonly wait years for the right diagnosis. Diagnosis involves a detailed history from family members (crucial, since the person may not see the changes), neurological and cognitive exams, speech and language assessment, and brain imaging. MRI may show shrinkage of the frontal and temporal lobes, and FDG-PET can show reduced activity. Seeing a neurologist or a specialized memory center is recommended. See Getting a Diagnosis.

Treatment

There is no cure or medicine that slows FTD yet, and the drugs used for Alzheimer's (such as cholinesterase inhibitors) generally don't help and may worsen behavior. Care focuses on managing symptoms:

Antidepressants such as SSRIs or trazodone may reduce compulsive behaviors, irritability and agitation in some people.
Antipsychotics are used rarely and cautiously because of side effects.
Speech-language therapy and communication aids help people with PPA.
Physical and occupational therapy for movement and daily tasks.
Structure and environment – routines, supervision of money and driving, and limiting access to food or alcohol if needed.

Clinical trials, including ones targeting specific genetic forms, are active; see Joining a Clinical Trial.

Special challenges for families

FTD often hits people still working and raising children. Families may face job loss, financial strain, legal issues from impulsive behavior, and grief over personality changes in someone who still looks healthy. Helpful steps:

Arrange legal and financial protections early (power of attorney, monitoring accounts). See Caregiving Guide: Where to Start.
Look into disability benefits—FTD is on the Social Security Administration's Compassionate Allowances list, which speeds up disability claims.
Explain the illness to children, schools and employers.
Connect with others: the Association for Frontotemporal Degeneration (theaftd.org) runs a helpline and support groups.
Look after yourself—see Caregiver Stress and Burnout.

Outlook

FTD progresses at different rates; average survival is often cited as about 7 to 13 years after symptoms begin, depending on the type. With the right diagnosis and support, families can plan ahead and maintain quality of life for as long as possible.

Sources

Not medical advice. This article is general information, not a diagnosis or treatment plan for any individual. Talk with a doctor about your situation.

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