Diagnosis of ‘gaffe disease’, prevalent from the age of 50, can take six years

Loss of interest in self-care, such as cutting your hair and getting your nails done, binge eating and inappropriate behavior in public are some of the symptoms of FTD (frontotemporal dementia), popularly known as faux disease. The disease, which alters the way of acting, is correctly diagnosed late – it can take six years, according to experts.

Psychiatrist and psychogeriatrician Valeska Marinho, coordinator of the Center for Alzheimer’s Disease at the UFRJ Institute of Psychiatry (Federal University of Rio de Janeiro), spoke about the subject in a lecture on diagnostic and therapeutic aspects of non-Alzheimer dementias at Brain Congress 2022, in Gramado (RS), last week.

“Diagnosis is very difficult, because FTD can be confused with a primary psychiatric illness, as a rule, with bipolar disorder or other dementias. It basically affects behavior and personality”, said the doctor. There are resources available to reach the diagnosis, such as neuropsychological assessments and tests that help identify where there is greater damage in the brain.

DFT also has other signs. It is capable of transforming a person with ordinary habits into an accumulator. There is a loss of interest in work, hobbies and outings. Tough depression that doesn’t get better with usual treatment, is an important alert, in addition to apathy, inattention, irritability, loss of empathy and the ability to recognize the other’s emotions and feelings. Often, the symptoms are not valued by the family.

The disease is progressive and the second most common cause of degenerative dementia, after Alzheimer’s disease. It affects the frontal and temporal lobes of the brain, whose functions include regulating behavior. There are several forms of FTD, each associated with the abnormal accumulation of some protein, such as tau and TDP-43.

It usually affects people over the age of 50 — more women than men. In about 20% of cases, a family inheritance is observed.

FTD has no specific treatment. “No drug for dementia available on the market is able to provide a benefit to the patient. So, the treatment ends up being symptomatic. We treat symptoms, such as depression and apathy. There are non-pharmacological approaches. In general, music therapy and physical activity, that promote greater control of symptoms, from the point of view of improving depression and anxiety”, says the doctor.

“With no specific medication available, as practical suggestions for treatment, from the diagnosis of FTD, we have trazodone and second-generation antipsychotics, which bring an improvement in compulsive behavior, depression and reduce symptoms in general.”

According to the WHO (World Health Organization), about 55 million people live with dementia in the world, a contingent that increases at a rate of 10% per year. By 2030, that number could reach 78 million, and by 2050, 139 million. The global cost of the disease is US$ 1.3 trillion (R$ 6.48 trillion), estimates the entity, and could reach US$ 2.8 trillion (R$ 14 trillion) in 2030.

The reporter traveled at the invitation of Brain Congress 2022