Dementia doesn't always signal Alzheimer's

The degenerative brain disease known as frontotemporal dementia often escapes diagnosis for years, mimicking instead psychiatric and movement disorders.

By Susan J. Landers, AMNews staff. April 21, 2008.

Washington -- Dementia in people younger than 65 isn't always the result of early-onset Alzheimer's disease. Frontotemporal lobar degeneration, or FTLD, an umbrella term that covers several brain disorders, is another cause of early dementia, although one that is not widely recognized.

The announcement last fall by Sen. Pete Domenici (R, N.M) that he has FTLD placed a spotlight on the condition, at least momentarily. However, FTLD remains very much in the shadow of Alzheimer's.

About 250,000 Americans are believed to have FTLD, and 250,000 to 640,000 are estimated to have early-onset Alzheimer's.

Neither disorder can be cured. Although Alzheimer's is diagnosed fairly readily, FTLD is frequently misdiagnosed as a psychiatric or movement disorder, according to presenters at the Annual Conference of the National Council on Aging and the American Society on Aging held March 26-30 in Washington, D.C.

FTLD often occurs when people are in their 40s and 50s, about a decade earlier than Alzheimer's disease. Its unexpected appearance can place a tremendous burden on younger families with teens living at home, and work and income issues to be resolved. Its cause is not known.

Both Alzheimer's disease and FTLD cause brain cells to die. However, because they affect different regions of the brain, each triggers distinct abnormalities, said Sandra Weintraub, PhD, professor of psychiatry, behavioral sciences and neurology at Northwestern University's Feinberg School of Medicine in Chicago.