BvFTD (What Is Behavioral Variant Frontotemporal Dementia?)

bvftd

Through years of study and research, we finally bring you a complete overview of Behavioral variant frontotemporal dementia (bvFTD).

One of the MOST COMMON forms of frontotemporal degeneration.

This is a variant that develops when there is progressive cell loss in the anterior and frontal areas of the brain.

It usually results in alterations in behavior, personality, and complex thinking.

This type of dementia is said to be the 2nd leading cause of cognitive disorder brought about by neurodegeneration in persons who are 65 years and below.

Causes of Behavioral Variant Frontotemporal Dementia

causes of behavioral variant frontotemporal dementia
The main cause of the illness is yet to be established.

Scientists acknowledge that with the disease, there is usually a HUGE build-up of different types of proteins with brain cells.

Experts talk about three kinds of protein i.e. TDP=43, tau, and FUS (fused – in sarcoma).

These types of proteins usually occur normally but the problem comes in when there are EXCESSIVE AMOUNTS in the brain.

Large amounts of protein in the brain cells make the cells lose their ability to function well and they finally die off.

When this happens, the affected parts of the brain will shrink.

As aforementioned, it is right to conclude that this type of dementia may occur when there is cell loss in the frontal and anterior part of the brain.

To add to this, it is important to mention that this dementia can also be caused by different pathologies.

These include the irregular deposits of proteins in the brain.

Some studies also suggest that genetics may have a role to play in the development of the illness.

Symptoms of bvFTD

symptoms of bvftd
There are several symptoms that can indicate a person has behavioral variant frontotemporal dementia.

1. Disinhibition

This is one of the hallmark features of the illness.

People with this type of dementia will often show changes in behaviors that are socially acceptable.

It is where you may find a person touching or approaching strangers inappropriately.

Some will lose their decorum or mannerisms where they can end up using vulgar language, being rude, or violate personal space among others.

Others will even start engaging in impulsive buying or selling habits or get into careless actions among many others.

2. Executive dysfunction

You may also tell that a person has this kind of dementia when they START STRUGGLING with executive functions like generation of ideas, planning, mental flexibility, and organizing.

This primarily happens when the brain starts to lose some essential cells in its frontal lobes.

3. Loss of empathy

It is common for dementia patients to appear detached, cold, or display an abnormal disregard for distress or pain.

Some will also start to show a diminished response to other people’s feelings and needs.

4. Dietary changes

Change in eating habits is another example of symptoms that a person may have when dealing with this dementia variant.

This may manifest in the form of binge eating which may lead to weight gain or restrained eating that causes one to lose weight.

Some folks may hate some foods they used to love before and others will have food fads where they only want to consume a specific type of food.

Other individuals will start oral exploration where they want to consume INEDITBLE objects.

5. Inertia

Another symptom that comes out for people with this dementia is a general loss of motivation, drive, or interest.

In extreme cases, individuals will require some form of push to continue or initiate daily living activities such as taking a bath or dressing.

Many caregivers will mistake this for depression.

6. Compulsive behaviors

These can range from harmless repetitive behaviors like picking, tapping, and scratching.

Others will be quite complex such as collecting, ordering, and cleaning.

At extremes, impulsivity can end up being self-destructive.

For instance, a person may think that it is proper to jump out of a moving car on the highway. Some individuals also end up indulging in inappropriate sexual behaviors.

7. Impaired judgment

Although this may come in later, you may find that a person who has this type of dementia is not capable of making the right decisions.

This means that they can easily become victims of scams in person or online.

Sadly, people with the illness rarely notice the changes they go through.

Similar to other types of FTD, symptoms usually start mildly and become more disabling and pronounced over 8-10 years.

The end-stage of this illness typically includes intense functional impairment. It is also possible that a person will experience memory or motor difficulty if not both.

It is advisable to SEEK MEDICAL ATTENTION when you notice any of the symptoms above to get a timely diagnosis.

Diagnosing BvFTD

diagnosing behavioral variant frontotemporal dementia
To date, experts still do not have an easy time diagnosing this kind of dementia.

Given the gradual personality and behavioral changes that a person goes through, diagnosing this syndrome is not a walk in the park.

People will the illness will often go through SEVERAL mental and physical health referrals before the doctor can satisfactorily recognize the disease as a neurodegenerative disorder.

You may notice that a majority of the symptoms discussed above are synonyms with those of other dementia types. Something that increases the chances of MISDIAGNOSIS.

For early detection, there must be in-depth expert assessments of a person’s:

  • Medical history
  • Cognitive functions
  • Clinical observations
  • Caregiver reports on psychological and behavioral symptoms and the changes they bring.

Doctors and psychologists work hand in hand to assess a person’s current situation before concluding whether they have the disease or not.

An individual might have to undergo a couple of medical tests.

These may include brain scans which can show if there is a loss of brain cells in the FTD.

The professionals may also recommend blood tests, MRI, CT and other tests to confirm the clinical diagnosis.

This helps to rule out any other diseases because there is no single test that can diagnose this kind of dementia.

Treating bvFTD

treating bvftd
There is still no cure for this type of dementia. Doctors may, however, prescribe some medications that can help to manage the symptoms.

Some of these drugs may include SSRIs.

These are selective serotonin reuptake inhibitors that can help a person manage symptoms like irritability, agitation, and lack of motivation.

Medical practitioners will also treat other illnesses that a person may have like high blood pressure, diabetes, and high cholesterol.

Other than medications, there are other ways persons with the illness can get relief.

This includes physical exercise, getting enough sleep, therapies, and consuming a balanced diet.

This helps to ENHANCE health while IMPROVING general fitness and daily mood.

Antipsychotics may also be prescribed to take care of severe disinhibition as well as physical and verbal outbursts.

Remember that a person with bvFTD should never start taking any type of medication without consulting their doctor first.

This is because they may end up choosing the wrong type of drugs that may end up causing them harm.

Note: Because a certain type of medication works with one person, you may not automatically get the same results.

Different people usually have different experiences with frontotemporal dementia.

Examples of medications to AVOID include the ones that have powerful anticholinergic side effects.

These may include narcotics, antihistamines, muscle relaxants, central nervous system stimulates, and barbiturates among others.

An individual may also opt to join a clinical trial to see if the practitioners can make him or her feel better.

Research continues when it comes to the treatment of this illness and there may be a breakthrough in the future.

Coping with Behavioral Variant Frontotemporal Dementia

coping with behavioral variant frontotemporal dementia
The lack of an FDA approved cure means that a person with bvFTD must learn to cope with the illness to live a LONG and FILFILLING LIFE.

This includes getting help from friends, relatives, and professionals whenever they are in need.

However, many people SHY AWAY from asking for, especially when it comes to simple tasks.

It is also important to access the living environment of the person with dementia to ensure it is safe and comfortable.

A suitable retirement facility should be considered if living at home is no longer ideal.

It is also advisable for persons with the illness to get into legal planning when the dementia is still in its early stages.

Here, he or she can articulate their wishes and needs.

At some point it may be advisable to have a LIVING WILL which will spell out any medical treatments that a person may like to keep them alive as well as other decisions like organ donation and pain management.

Power of Attorney may also be necessary so that there can be a trustworthy person who can act in place of the ill individual in regards to financial and medical matters.

BvFTD Closing Thoughts

With bvFTD, it is essential to note that the length of the disease, as well as the symptoms, can dramatically vary from one person to the next.

Research shows that people who have this kind of dementia usually have a lower life expectancy when compared to the ones who have Alzheimer’s disease.

The disease usually CHANGES with time. A person can live with the illness for years.

Death may not be necessarily caused by the illness directly.

In most cases, it is because of other complications like dehydration, pneumonia, extensive pressure ulcers, UTI, fractures, falls, or vascular events.

Behavioral Variant Frontotemporal Dementia

behavioral variant frontotemporal dementia

Behavioral variant frontotemporal dementia (BvFTD) is one of the most common types of dementia that is called FTD (frontotemporal dementia).

It accounts for around half of the cases of this disease.

What is BvFTD

Brain condition called FTLD (frontotemporal lobar degeneration) causes FTD. BvFTD is a kind of frontotemporal dementia because it affects the temporal and frontal lobes of the brain.

Another name for the disease is also Pick’s disease. Some doctors also use terms frontotemporal disorder or frontal lobe disorder.

The brain’s frontal lobe controls essential facets of daily life such as emotional control, judgment, behavior, planning, multitasking, inhibition, and executive function.

The temporal lobe, on the other hand, primarily affects language, behavior, and emotional response.

Symptoms of Behavioral Variant Frontotemporal Dementia

symptoms of behavioral variant frontotemporal dementia
The symptoms of BvFTD start mildly and progressively become worse over time.

The rate of progression, however, varies from one person to another. A person may experience various emotional and behavioral issues like:

  • Withdrawal from social interaction
  • Poor personal hygiene
  • Abrupt mood changes
  • Difficulty keeping a job
  • Disinterest in previously enjoyable activities
  • Inappropriate or compulsive behavior
  • Apathy
  • Hoarding
  • Repetitiveness

An individual with BvFTD may also experience neurological and language changes such as:

The symptoms of this type of dementia usually start showing for people who are between 40-60 years.

In some cases, they can be seen in persons who are as young as 20 years.

Most people with frontotemporal dementia are between ages 45-64.

Persons with Pick’s disease rarely recognize when they change their behaviors or the effect this has on others around them.

Causes of BvFTD

causes of bvFTD
Frontotemporal dementia is normally caused by abnormal amounts of tau which is a kind of nerve cell protein.

These proteins exist in all nerve cells.

If a person has Pick’s disease, the proteins will accumulate into clumps in the brain’s temporal and frontal lobe which can result in the death of cells.

After the cells die, the brain tissue will start to shrink which will result in dementia symptoms.

It is not yet clear what causes the formation of these abnormal proteins in the nerve cells.

Some studies indicate that genetics play a role in the development of this kind of dementia.

This is because about 40% of people with behavioral variant frontotemporal dementia usually have a family history of at least one relative who has been diagnosed with a neurodegenerative disease.

For the rest of the people, the development of this type of dementia is known to be sporadic. It does not relate to genetics, as none of their relatives has FTD.

Stages of Behavioral Variant Frontotemporal Dementia

stages of behavioral variant frontotemporal dementia
BvFTD usually occurs in three main stages as explained below.

Early Stage BvFTD

The early stages of FTD usually have some unique features. At this stage, memory loss is usually not prevalent.

A person may, however, experience changes in social and personal behavior. Most individuals will start to disregard social boundaries or start engaging in activities that may be deemed inappropriate.

They can end up behaving carelessly, impulsively, and in some cases criminally.

The ability to handle money may deteriorate and the concern for other peoples’ feelings may start to diminish.

Misdiagnosis also occurs often during this initial stage. This is because a specialist can easily misdiagnose or overlook it as a psychiatric condition.

Middle Stage BvFTD

In the middle stage, the symptoms of BvFTD become more similar to those of frontotemporal dementia.

They may even resemble those of other types of dementia such as Alzheimer’s disease.

At this point, people with progressive disease may require some assistance with day to day activities like bathing, dressing, and grooming.

Disturbances of behavior became more consistent.

Most people will also start developing language problems.

Late-Stage BvFTD

The final stage of the illness is usually the most challenging. Language and behavior problems become worse and memory deterioration also happens fast.

For most people, it may be necessary to have round-the-clock care to ensure adequate safety and care.

BvFTD Diagnosis

bvFTD diagnosis
Diagnosis for Pick’s disease (or BvFTD) is usually not an easy task, especially in the early stages.

Many times, medics can misdiagnose it for other conditions like depression, Alzheimer’s disease, Parkinson’s disease, vascular dementia, drug or alcohol dependence, or other psychiatric disorders.

The symptoms a person showcases and the results of neurological examinations are key to behavioral variant frontotemporal dementia diagnosis.

Glucose positron emission scans and brain scans like MRIs (magnetic resonance imaging) are also helpful in the diagnosis process.

These must, nonetheless, be interpreted in the context of an individual’s neurological exam and medical history.

Treatment Options

treatment options for bvftd
Currently, the FDA has not approved any medication that can be used to treat BvFTD.

In a majority of the cases, it may not be possible to slow down the progression of symptoms.

Environmental and behavioral interventions are considered some of the most effective options for managing symptoms.

Experts advocate for the use of distracting and reassuring tactics instead of challenging disruptive behaviors that can lead to more agitation.

Some doctors can also recommend pharmacological measures to help relieve distressing symptoms. The role of medication in frontotemporal dementia intervention is still not clear.

Selective SSRIs (serotonin reuptake inhibitors) are used to treat challenging behaviors.

Antipsychotics like olanzapine have been used on individuals suffering from prominent psychosis and agitation.

Studies are, however, on-going to try and introduce an effective treatment option for BvFTD.

Behavioral Variant Frontotemporal Dementia Prognosis

behavioral variant frontotemporal dementia prognosis
Years after positive BvFTD diagnosis, affected persons usually start to showcase problems with coordination and muscle weakness.

This can leave a person bedbound or needing a wheelchair.

The problems can result in difficulties with chewing, swallowing – eating in general – controlling bladder/bowels, and moving.

In the long run, persons with frontotemporal degenerations die because of physical changes that cause lung, skin, or urinary tract infections.

From the onset of symptoms, the average life expectancy is approximately 8-9 years. Some people may live up to 20 years or more with this progressive disease.

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