The family of Bruce Willis recently revealed that the actor has been diagnosed with 额颞叶痴呆，即FTD. While you’ve likely heard of 痴呆 and associate the health condition with aging adults, FTD is much less common than 阿尔茨海默病 and often affects people who are younger.
“The majority of FTD happens earlier in life, about 65 years old or younger,” says 克里斯汀·克莱特·布朗，医学博士, a board-certified specialist in behavioral 神经学 and assistant professor in the Division of Cognitive 神经学 at University of Utah Health. “About 15 to 22 out of 100,000 people develop FTD.”
Like 阿尔茨海默病, FTD is a type of 痴呆, or a 神经generative disease of the brain. It commonly impacts behavior, 演讲, 语言, 决策, 和记忆, interfering with daily life and function. While both FTD and 阿尔茨海默病 are progressive degenerative diseases where symptoms get worse over time,y are caused by different proteins in the brain that accumulate and lead to damage of the brain cells. FTD causes nerve cell damage in the frontal and/or temporal lobes of the brain, which leads to loss of function in these regions.
What are the symptoms of FTD?
Symptoms of FTD can vary, depending on what part of the brain it impacts and the underlying problem. A person with FTD may experience:
- Changes in behavior, such as:
- Saying or doing inappropriate things
- Developing new obsessions or compulsions
- 严重丧失动力
- Changes in diet, such as obsessively eating sweets
- Changes in 语言 (also called aphasia), such as:
- 找词困难
- 理解单词有困难
- 正常语法的丧失
- Difficulty pronouncing words
- Changes in executive function, such as:
- Difficulty with complex 决策, multi-step tasks like cooking and packing, 或者使用电话, 电脑, 或遥控
谁有风险？?
People at highest risk for developing FTD are those with genetic mutations causing FTD. “FTD is much more commonly genetically inherited than 阿尔茨海默病 is,Cliatt Brown说. People with a family history of young onset 痴呆 (around age 60 or younger) or a family history of 肌萎缩性侧索硬化症, 也被称为 卢伽雷氏症, are also at higher risk of FTD. This is because there may be a genetic mutation that caused 痴呆 or 肌萎缩性侧索硬化症 in their relatives.
如何诊断FTD?
A 神经logist will usually discuss cognitive and behavioral changes with the patient, 家庭成员, or close friends to see how changes have developed over time. A patient may also undergo:
- 认知测试
- MRI brain imaging to see the structure of the brain
- PET scan of the brain to determine whether areas of the brain aren’t functioning as well as they should
Shrinking of the frontal and/or temporal lobes is usually an indicator of FTD. Finding the correct diagnosis is important in determining what type of medications should be used. 例如, 阿尔茨海默病 has different medications that are not effective for patients with FTD.
Finding a clear diagnosis can also provide answers to the patient and their family. “When a loved one is having significant cognitive decline that impacts the ability to function in daily life, 这是非常令人沮丧的,Cliatt Brown说. “Finding the diagnosis gives them an answer.” This diagnosis can also help a family better understand their personal risk of developing FTD.
FTD的进展如何?
FTD worsens gradually over several years. “Unfortunately, it does shorten the life span,Cliatt Brown说. “The average survival time from the time of development of symptoms is about 8 to 10 years, but it can vary person to person.” While some people can progress fast, others may have a slower progression.
FTD可以治疗吗?
There are currently no treatments to stop or slow down progression of FTD.
How can a family member help?
If you notice any changes to behavior or 演讲 of a loved one, talk to their primary care doctor. A primary care doctor can perform initial cognitive screening to determine whether additional tests are needed. Your loved one may be referred to a 神经logist to investigate further.
Watching a family member or loved one go through FTD can be difficult. “It can be really hard for them not only to see these changes happen and not be able to do anything about it, but also to help take over those roles that their loved one isn’t able to do anymore,Cliatt Brown说.
Talk to your doctor about resources that are available to help you during this life transition. You can find more resources through the University of Utah 老化脑护理计划, Association for Frontotemporal Degeneration，和 阿尔茨海默氏症协会.