FTD Explained to Africans: Causes and Types  I  Symptoms and Diagnosis  I  Treatment

 

Frontotemporal Dementia Explained To Africans: Symptoms and Diagnosis

By Oluwasola Samuel, Freelance health writer. Medically reviewed by:  A. Odutola. MB.BS,, PhD, FRCSEd.

 

Portrait of an elderly African man dressed in cultural attire with a black skull cap and sitting with both hand on a cane, against a brown background. In the foreground are the words of a caption: Frontotemporal Dementia: Symptoms and Diagnosis in yellow colour framed in red outline. Image credit: Freepik.

 

Key Points

• Early symptoms and signs of frontotemporal dementia may be signalled by big shifts in personality or behaviour, like acting differently, being socially awkward and out of character or struggling with speech. Some people may also develop tremors, muscle spasms, poor coordination and high risk of falls.

• The diagnosis of frontotemporal dementia is not easy to make and requires specialist doctors and other healthcare providers like neurologists, psychiatrists, and psychologists working together as a care team.

• A detailed history with comprehensive general physical examination including detailed neurological and psychological examination plus laboratory and imaging tests form the basis by which a working diagnosis of FTD can be made. This is after excluding conditions like cerebrovascular disease, stroke, brain tumors, etc., that may be confused with it.

 

What if your loved one suddenly starts acting strangely? For example, becoming rude, forgetful, or speaking less? It might not be a spiritual attack or old age. It could be something different (frontotemporal dementia or FTD). FTD is a lesser-known brain condition that hits people even in their 40s. Many Africans, including healthcare professionals misunderstand FTD or completely miss what it is. 

This article breaks it down in simple terms, like how to know if you or a loved one may suffer from frontotemporal dementia, and how it’s diagnosed, so you can better protect your family and community.

 

Symptoms of Frontotemporal Dementia

Frontotemporal dementia (FTD) causes changes in behaviour, personality, and language abilities. These changes depend on which subtype of FTD a person has. Below are the key symptoms grouped by the main types of FTD.

1. Behavioural Variant FTD (bvFTD)—Personality & Behaviour Changes

This is the most common type of FTD. Symptoms from behavioural variant FTD mainly affect behaviour and social skills.

Symptoms include:

• Loss of empathy: becoming cold, insensitive, or indifferent to others' feelings.

• Impulsive or inappropriate actions: making rude comments, overspending, or engaging in unusual or risky behaviours.

• Changes in eating habits: overeating, craving sweets, or refusing to eat certain foods.

• Poor judgement & decision-making: falling for scams, neglecting responsibilities, or making bad financial decisions.

• Lack of motivation: becoming passive, neglecting personal hygiene, or losing interest in work and hobbies.

• Repetitive behaviours: doing the same action (like tapping, humming, or collecting objects) repeatedly.

2. Primary Progressive Aphasia (PPA)—Language Problems

This type affects speech and communication, with three subtypes, namely:

A. Semantic Variant PPA (svPPA) – Trouble Understanding Words

Symptoms include:

• Forgetting the meanings of words (e.g., asking random questions like, "What is a pen?")

• Struggling to name objects or people

• Speech becomes vague (e.g., saying "thing" instead of specific words).

B. Nonfluent/Agrammatic PPA (nfvPPA) – Trouble Speaking Clearly

Symptoms include:

• Difficulty pronouncing words

• Understanding speech is usually better than producing it.

C. Logopenic PPA (lvPPA)—Trouble Finding Words

Symptoms include:

• Frequent pauses while speaking to search for words

• Difficulty repeating long sentences

• Speech remains grammatically correct but sounds hesitant.

3. Movement-Related Symptoms (FTD-MND, PSP, CBS)

Some people with FTD also develop motor problems.

Symptoms include:

• Muscle weakness, stiffness, or tremors (FTD with motor neuron disease, similar to ALS) 

• Balance problems and frequent falls (progressive supranuclear palsy)

• Difficulty coordinating movements (corticobasal syndrome)

 

Diagnosis of Frontotemporal Dementia

Like Alzheimer’s dementia, the definitive diagnosis of frontotemporal dementia can only be made after death when brain tissue is studied at autopsy (post-mortem). That said, even the  probable or possible clinical diagnosis of the condition can be challenging because its early symptoms often resemble psychiatric disorders like depression, bipolar disorder, or other dementias like Alzheimer’s. [10]

There is no single test that can diagnose probable FTD. However, your healthcare professional can use a combination of clinical processes and tests to rule out other conditions and improve the clinical suspicion of confirm FTD. [3]

Some of these clinical processes and tests include:

1. Medical history and symptoms review

Your neurologist or psychiatrist will ask you or a family member about:

• Noticeable changes in behaviour, personality, or language.

• How long the symptoms have been present?

• If there is any family history of dementia or ALS (since some FTD cases are genetic).

2. General and Neurological Physical Examination

Your neurologist or psychiatrist will conduct a full physical and neurological examination on you, including focused cognitive (higher-order brain functions) and behaviour assessments.

A. Cognitive assessments will include:

• Language skills (naming objects, repeating phrases).

• Problem-solving and judgement.

• Memory (though memory loss is not the main early sign of FTD).

The simple tools of cognitive assessment include:

• The mini-mental state examination (MMSE), which provides a quick assessment of general cognitive function. A standard MMSE evaluation form is available here. 

• The Montreal Cognitive Assessment (MoCA), which offers a more detailed evaluation of executive function and language skills.

• The functional cognitive assessment (FCA) provides valuable insights by examining the caregiver’s report, capturing behavioural changes, and daily life challenges. 
• Additional specialised tools may also be used as considered necessary by your doctor

Together, these tools are used to complement brain imaging (CT and MRI scans) and clinical evaluations to create a comprehensive diagnostic approach for FTD.  

B. Behavioural interviews with family members (since patients might not be aware of these symptoms).

3. Brain imaging

• CT scan: This uses X-rays to produce a computerised and helpful map of the brain for purposes of excluding conditions such as stroke or tumours that could mimic FTD.

• MRI scan: This uses radio waves within a magnetic field to also produce a more detailed map of the brain than the CT scan achieves. It may show clearer evidence of shrinkage (atrophy) in the frontal and temporal lobes of the brain and also better exclude the presence of stroke or tumors.

• PET scan: PET stands for Positron Emission Tomography.  It is a tool that uses radioactive agents to study the structure and functions of organs of the body at cellular levels. It may be used in FTD, to detect abnormal protein buildup (e.g., tau or TDP-43) or reduced brain activity in key areas.

Findings from these tests do not give a definitive confirmation of FTD. They only help to eliminate any other possible conditions aside from FTD that can cause damage to the frontal and temporal lobes of the brain.

 

Challenges in Diagnosing FTD in African communities

The diagnosis of frontotemporal dementia (FTD) poses significant challenges in Africa, much like Lewy body dementia, due to lack of awareness, limited healthcare resources, including skilled personnel, and cultural stigma surrounding neurodegenerative disorders. 

Most people within African communities often attribute neurodegenerative conditions to supernatural causes, thereby delaying proper treatment. The low availability of specialised neurology services, high diagnostic costs, and competing health priorities further hinder care, while carers struggle with minimal support. 

In addition, scarce research on FTD in Africa leaves gaps in understanding its occurrence and progression in local populations. [11] 

Addressing these issues requires improvements in medical education, healthcare infrastructure, funding for research, and policy reforms to support affected individuals and their families.

 

When to See a Doctor

You should see a doctor if you or a loved one begins to experience:

• Personality or behaviour changes (e.g., sudden mood swings, loss of empathy, impulsivity)
• Sleep problems with hallucinations
• Multiple falls and poor coordination of movements
• Difficulty with language (e.g., trouble finding words).
• Confusion about time or place (e.g., getting lost in familiar areas).
• Decline in judgement (e.g., poor financial decisions, neglecting hygiene).
• Memory problems that disrupt daily life (e.g., forgetting important dates).

The earlier a doctor is seen following experiencing any of the above symptoms, the early a diagnosis can be made and early symptom management started. 

If symptoms are sudden or severe, you or a loved one must seek immediate emergency medical attention.

 

Conclusion 

Frontotemporal dementia is a complex brain disease that often goes unnoticed or misunderstood, especially in African communities. Families of a person living with FTD can seek better support for them by recognising the symptoms early. Although diagnosis can be challenging, awareness is the first step toward getting the right care and planning for the future.

 

References

 

Related 

 

FTD Explained to Africans: Causes and Types  I  Symptoms and Diagnosis  I  Treatment

 

 

Published: July 14, 2025

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