What Type of Dementia Does Bruce Willis Have?

The news of Bruce Willis' diagnosis of frontotemporal dementia is heartbreaking. It leaves us wondering exactly what frontotemporal dementia is and what losses Bruce Willis and his family face.

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What Type of Dementia Does Bruce Willis Have?

What is Frontotemporal Degeneration?

Frontotemporal degeneration, or FTD for short, is a progressive neurological disease that affects the frontal and temporal lobes of the brain. Other names for FTD include frontotemporal dementia, frontotemporal lobar degeneration (FTLD), and Pick's disease.

FTD affects about 50,000 to 60,000 Americans.

It is thought that about 40% of people with frontotemporal degeneration may inherit the disease; there are no other known risk factors.

According to the Association for Frontotemporal Degeneration, FTD is the most common cause of dementia for people under age 60. Alzheimer's disease and FTD  belong to the same family of neurodegenerative diseases; however, FTD differs from Alzheimer's in that memory is preserved until late in the disease. 

Behavior, personality, language, and movement all gradually deteriorate in FTD disorders. 

Diagnosis and Symptoms

Initially, subtle but distressing cognitive, communicative, and behavioral changes may be evident only to close family and friends. 

There is no single diagnostic test for FTD. Diagnosis can be challenging. In the early phase of the disease, the doctor may not have enough evidence to support a clinical diagnosis.

A clinical diagnosis is made as symptoms worsen, typically augmented with an MRI. It is a relief for the family to have a precise diagnosis and explanation, even though the disease is progressive.

As the disease progresses, the individual experiences increasingly impaired cognition, decreasing functional ability, and is challenged with activities of day-to-day life. In end-stage dementia eating, swallowing, and interacting are difficult.

Symptoms

Symptoms are related to the area of the brain affected. They are the frontal and temporal lobes of the brain. Among the areas affected by FTD are those involved in personality, behavior, language, motivation, abstract thinking, and executive function.

Individuals demonstrate behaviors often associated with patients with traumatic brain injuries or left-hemisphere strokes. 

Frontal lobe

An individual with frontal lobe-focused abnormalities may display impulsivity and disinhibition, apathy, lack of disease insight, emotional blunting, and cognitive decline.

Food preferences can change. They may act and talk as if they lack a filter, are inappropriate, or are silly. They lose self-awareness and become inattentive to personal grooming.

When taking a history, a provider may ask the family,

  • "Has he done things to embarrass you?"
  • "Have food preferences changed?"
  • "Is he not as affectionate with his family or pets?'

The frontal lobe also drives judgment. Individuals with FTD can be susceptible to scammers or others who want to take advantage of them. 

Temporal lobe

The temporal lobe controls language. A hallmark of FTD is progressive language dysfunction. FTD can cause aphasia. Speech, writing, and comprehension are all affected by aphasia. 

There are many sub-types of aphasia, but they all affect the ability to communicate.

People with receptive aphasia may lose the ability to understand language. They can speak but do not make sense. They struggle with the meaning of words and may have difficulty recognizing unfamiliar objects or faces.

People with expressive aphasia lose the ability to produce language. They struggle with fluency, syntax, and grammar. They may not be able to retrieve the word they want.

FTD is not life-threatening, but people with the disease will need 24 hr care for safety. To learn more about the disease, visit the  Association for Frontotemporal Degeneration.

References

Image credit to Gage Skidmore

Association for Frontotemporal Degeneration

Khan I, De Jesus O. Frontotemporal Lobe Dementia. [Updated 2022 Oct 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559286/

Kirshner HS. Frontotemporal dementia and primary progressive aphasia, a review. Neuropsychiatr Dis Treat. 2014 Jun 12;10:1045-55. Doi: 10.2147/NDT.S38821. PMID: 24966676; PMCID: PMC4062551. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062551/

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Nurse Beth

About Nurse Beth, MSN

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Nurse Beth has 30 years experience as a MSN and specializes in Tele, ICU, Staff Development, Freelance Writer.

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Specializes in Med nurse in med-surg., float, HH, and PDN.

My mother-in-law has the same thing as Bruce Willis, but not the money or assistance of a large family. Oh well.

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Specializes in BS artist.

I knew there was something amuck with Bruce Willis when he let Demi Moore slip through his fingers. Imagine coming home to a babe like that.....

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