Series: What's Under the Dementia Umbrella?

Part 4.3: Pick's Disease Symptoms

In this series we are taking an in-depth look at the various types of dementia and how to improve treatment in a long-term care setting. There are several lesser known dementias affecting our seniors. As part of their care team we need to educate ourselves on how to better understand and meet their needs.

We have a large amount of important information to share with you concerning Pick’s Disease, or Frontotemporal Dementia, so we’ve broken it down into three posts. Today we’ll look at how you can help in the treatment of people who have this dementia and examine how it differs from Alzheimer’s Disease.

Treatment for FTD

There are currently no specific treatments for Frontotemporal Dementia or any of its subtypes. Antidepressants have shown modest success in reducing anxiety and depression. Medication for Parkinson's can also be helpful for a person exhibiting problems with movement, but they often only provide limited or temporary relief. Speech, vision and swallowing difficulties usually do not respond to any drug treatment.

Involving physical, occupational and speech therapy can help with managing movement and language symptoms. Exercises can keep the joints limber, and weighted walking aids—such as a walker with sandbags over the lower front rung—can help a patient maintain balance. Physicians will sometimes prescribe bifocals or special glasses called prisms for people with abnormal eye movements.

While there is no drug to cure FTD, we as caregivers can help residents who are experiencing its symptoms. Some approaches that will help us do this are:

• Taking time outs

Arguing or reasoning with a person with FTD is not helpful. They are not able to control their behaviors, nor are they even aware that their actions are unusual or upsetting to others. Instead, try to be as sensitive as possible and understand that it’s the illness talking, not the resident.

• Limiting choices or offering a specific choice

For example, try to use yes or no questions.

• Being consistent

Stick to routines and schedules. This decreases confusion and helps improve sleep.

• Exploring new environments

Offering new activities or moving to a different environment or room can help limit compulsive behaviors

• Using visual aids

When communicating with someone who has FTD, it helps to augment your words with something visual, such as drawings, pictures and gestures.

Key Differences Between FTD and Alzheimer's

As with many dementias, it can be easy to confuse FTD with Alzheimer’s. Here are some factors that differ between the two diseases.

• Age at diagnosis may be an important clue. Most people with FTD are diagnosed in their 40s through early 60s. Alzheimer's, on the other hand, grows more common with increasing age.

• Memory loss tends to be a more prominent symptom in early Alzheimer's than in early FTD, although advanced FTD often causes memory loss in addition to its more characteristic effects on behavior and language.

• Behavior changes are often the first noticeable symptoms in bvFTD, the behavior variant frontotemporal dementia subtype and most common form of FTD. Behavior changes are also common as Alzheimer's progresses, but they tend to occur later in the disease.

• Problems with spatial orientation—getting lost in familiar places, for example—are more common in Alzheimer's than in FTD.

• Trouble with speech is more prominent in FTD. Although people with Alzheimer's may have trouble thinking of the right word or remembering names, they tend to have less difficulty making sense when they speak, understanding the speech of others or reading than people with FTD.

• Hallucinations and delusions are relatively common as Alzheimer's progresses, but relatively uncommon in FTD.

Learn more online: Frontotemporal Disorders Guide from the National Institute on Aging (NIA).

Did you miss our previous FTD posts? See our overview of the disease here and learn about its symptoms here.