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FTD vs Alzheimer’s – Bruce Willis’ Dementia is Not Alzheimer’s and Why

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  • Post last modified:May 28, 2024

If you’ve watched Die Hard, Armageddon or The Sixth Sense, you may be familiar with the actor Bruce Willis. Sadly, he was recently diagnosed with frontotemporal dementia (FTD).

People often ask: How is FTD different than Alzheimer’s? This article will answer that very question for you.

What Is FTD?

FTD is one of several forms of dementia. It is actually an umbrella term, encompassing a group of disorders characterised by a progressive degeneration of nerve cells in the frontal lobe or the brain regions underneath the ears. It usually shows up earlier than other forms. Symptoms typically start between the ages of 40 and 65, but FTD can strike young adults and those who are older. FTD affects men and women equally. The 2 most common types of FTD are the frontal variant and primary progressive aphasia.

The Frontal Variant

According to Neurologist Nicholas Milano, patients with the behavioural variant of frontotemporal dementia have a progressive change in their personality where they become disinhibited or maybe apathetic and have more trouble with problem-solving when it comes to their thinking.

For the frontal variant, there is accumulation of abnormal proteins (tau and TDP-43) in the frontal lobes of the brain, situated behind the forehead. The frontal lobes play a crucial role in regulating self-control, performing complex activities, and fostering empathy and sympathy. When the abnormal protein builds up in this region, individuals experience a loss of self-control regulation, diminished empathy and sympathy, and a decline in their ability to take initiative.

Primary Progressive Aphasia

This is the disease Willis was recently diagnosed with. Aphasia = Lack of Language. This time, the abnormal proteins accumulate in the temporal lobes and in a part of the frontal lobe just above the temporal lobe, a little bit further back — critical areas in the brain for language. When the pathologies accumulate there, individuals can have difficulty getting out an intelligible sentence.

Both have the same or similar pathologies, but it depends on where that pathology is in the brain. The average life expectancy of a patient diagnosed with frontotemporal dementia is nine years from the first symptom but five years from the first diagnosis, because usually there’s a delay in diagnosis.

How Is FTD Diagnosed?

A neurologist will conduct a comprehensive clinical examination and employ psychological testing to assess cognitive skills. In addition, diagnostic measures include a brain MRI to identify signs of atrophy or shrinking in specific brain regions. Blood tests are conducted to rule out treatable causes of cognitive impairment, such as thyroid disease or vitamin B12 deficiency. Brain metabolism imaging, specifically Positron Emission Tomography (PET), is often utilised to determine the involvement of frontal and temporal lobes, providing valuable insights into the neurobiological aspects of the disorder.

What Causes FTD?

Simply put, it’s unknown. Researchers have linked certain subtypes of FTD to mutations on several genes. Some people with FTD have tiny structures, called Pick bodies, in their brain cells. Pick bodies contain an abnormal amount or type of protein.

However, they were able to find out the proteins that accumulated, as well as the affected regions of the brain.

The Cure for FTD?

Unfortunately, there is none. According to Milano, because FTD is less common than Alzheimer’s disease, there probably hasn’t been as much research, and there haven’t been any treatments that have been shown to be beneficial.

One medication that has been useful for people who have behaviour problems associated with frontotemporal dementia are the SSRI family of medicines—the selective serotonin reuptake inhibitor. These are felt to improve some of the symptoms. For those who have language problems, we’ve also had good success early on, as have others, with speech therapy.

Most of the other work really comes with families learning to adjust to their loved ones’ difficulties. Willis’ doctors, family and friends are working together to make him feel as comfortable as possible, with the help of psychiatrists, speech therapists, neurologists and other specialists.

Thankfully, the BU Alzheimer’s Research Centre is working on using EEG electrodes to more easily be able to sort out who has different types of dementia.

How To Prevent FTD

In this specific form of dementia, it’s important to take early steps to prevent it, because it tends to strike between the ages of 45 and 65. A study published in the Alzheimer’s Association journal suggests that having an active lifestyle can reduce a younger adult’s risk of getting this disease.

To promote brain health, engaging in stimulating activities like puzzles, learning a new language or musical instrument, and participating in conversations is recommended. The suggested time commitment for these enriching activities is at least 30 minutes a day. For physical well-being, 150 minutes per week of moderate-intensity aerobic activity along with two days of weight training is advised.

However, caution is advised against overtraining to prevent potential injuries and exhaustion. Cortisol is toxic for the brain at high levels, so remember to keep stress levels at bay!