Yes. Frontotemporal dementia is progressive, and it often advances faster than Alzheimer's disease. It also begins earlier, commonly between the mid-forties and the mid-sixties, so early changes in behaviour or language are frequently attributed to stress or a psychiatric condition before the diagnosis is made.
Yes. Frontotemporal dementia is progressive, and it often advances faster than Alzheimer's disease. It also begins earlier, commonly between the mid-forties and the mid-sixties, so early changes in behaviour or language are frequently attributed to stress or a psychiatric condition before the diagnosis is made.
The presentation depends on which lobe bears the brunt. In the behavioural variant, the early changes are disinhibition, apathy that is mistaken for depression, loss of empathy, repetitive or compulsive routines, and a shift in eating towards sweet food or overeating. In the language variants, speech becomes effortful and ungrammatical, or word meaning is progressively lost while fluency is preserved. Memory is often relatively spared early, which is one reason the diagnosis is missed. Later, the variants converge and motor features may appear, overlapping with parkinsonism or motor neuron disease.
Three things conspire. The age of onset is younger than most people associate with dementia, so the possibility is not raised. Memory, which is what families and clinicians screen for, may test near normal at a stage when behaviour has changed markedly. And the presenting picture genuinely resembles a mood disorder, a personality change, a midlife crisis or a workplace problem. Diagnosis often depends on a detailed account from someone who knew the person well before the change, which is why that person's attendance matters.
There is no disease-modifying treatment, so management targets symptoms and the practicalities of daily life. Agents from the SSRI class can reduce disinhibition, compulsive behaviours and appetite change for some people. Cholinesterase inhibitors, used in Alzheimer's disease, are not indicated here and can make behaviour worse. Antipsychotics are used with real caution given their risks in dementia generally. Non-drug approaches, particularly structuring the environment and routine to reduce triggers, often achieve more than medication does.
Because onset is early, the practical consequences land on people still working, driving and supporting a household, and addressing those is a large part of care. Capacity for financial decisions, access to accounts, driving safety, employment and disability provision are worth raising early rather than after a crisis. Speech and language therapy helps in the language variants. A meaningful proportion of cases have a genetic cause, so genetic counselling is offered where the family history suggests it. Imaging is arranged at an imaging centre.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: National Institute on Aging: frontotemporal disorders; MedlinePlus: dementia; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.