Frontotemporal dementia usually begins at a younger age than Alzheimer's, so daily life is dominated by employment, finances and family roles rather than by memory. Loss of insight means the person often does not perceive a problem, which shapes everything.
Frontotemporal dementia usually begins at a younger age than Alzheimer's, so daily life is dominated by employment, finances and family roles rather than by memory. Loss of insight means the person often does not perceive a problem, which shapes everything.
Many people are diagnosed in their fifties or sixties, often while working and sometimes with dependent children or a mortgage. The consequences are practical and urgent: capacity to work, income protection, disability benefits, and financial decisions made before the diagnosis that may need reviewing. Impulsive spending is a recognised early feature, so financial safeguarding is frequently needed sooner and more actively than in later-onset dementias. These are not secondary concerns; they are usually the presenting crisis.
This is the hardest part for families and it is worth naming clearly. Loss of insight is a feature of the illness, not denial or stubbornness. The person may genuinely not perceive the changes others see, which means reasoning, explaining and persuading do not work in the way they would otherwise. Strategies that work tend to be environmental rather than argumentative: removing opportunities rather than winning agreement, redirecting rather than correcting, and accepting that some conversations cannot be resolved.
Behavioural change including loss of empathy, socially inappropriate remarks and altered eating is distressing partly because it looks like personality change rather than illness. Where the language variants dominate, communication strategies matter more: simple sentences, extra time, and using writing or pictures. Family strain in this condition is particularly high, partly because the person appears physically well and partly because the changes affect relationships directly. Support for the carer is not optional here.
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: MedlinePlus: Alzheimer disease; National Institute on Aging; MedlinePlus: memory.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.