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6 signs your dog could have dementia
Signs of dementia typically appear in senior dogs, or dogs in the last 25 percent of their lifespan.
Author of the article:Washington Post
Washington Post
Jane Sykes
Published Sep 09, 2026 • Last updated 1 day ago • 4 minute read
Closeup photo of an adorable dog.
Photo by SasaStock /Adobe Stock
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While dogs don’t get Alzheimer’s disease, older dogs can develop a strikingly similar condition called canine cognitive dysfunction syndrome – which I’ll refer to as dog dementia from here on, although vets prefer the term CCDS. This is a common, chronic, age-related condition that progresses slowly over time, can’t be attributed to other diseases and has an impact on a dog’s daily life.
Up to 60 percent of dogs older than 8 develop dementia, and a dog’s susceptibility increases by at least 50 percent every year after. Caring for a dog with dementia can be emotionally draining and time-consuming, though there are ways to slow the progression, and you and your pet can still continue enjoying meaningful time together.
Signs of dementia typically appear in senior dogs, or dogs in the last 25 percent of their lifespan. For small dogs (less than 20 pounds), this is about age 8 to 10; for large dogs, signs can begin as early as 6 years old.
While improvements in pet health care can mean longer pet lifespans, it also means you’re more likely to end up caring for a senior pet – one that is at risk for developing dementia.
Just as the Alzheimer’s Association has identified 10 warning signs of early Alzheimer’s in people, a group of veterinary neurologists, behaviourists, and other experts (known as the CCDS Working Group) use the acronym DISHAA to describe six signs that your dog could have dementia. Knowing these signs can help you and your vet identify dementia earlier, so that you can better manage it.
1. Disorientation: Disoriented dogs do things like stare at walls, get stuck in corners or go to the wrong side of the door to be let out.
2. Impaired social interactions: These could include attention-seeking behaviours or decreased interactions with other pets and people, such as not responding to petting or no longer greeting you at the door when you get home from work.
3. Sleep disturbances: Pacing or whining during the night or being difficult to wake during the day.
4. House soiling, learning and memory deficits: Forgetting potty-trained behaviours as well as other commands such as “sit” and “stay,” or pawing at the door to go outside after just being let in.
5. Activity changes such as restlessness, aimless pacing or losing interest in going on walks or playing with toys.
6. Anxiety and fear: Showing signs of irritability, increased aggression or clinging to their owners more than usual.
Early on, dogs with dementia can have signs such as increased sleeping and decreased social interactions that you might think are due to old age. As things progress, problematic issues like house soiling and pacing at night crop up – things that may prompt you to make changes such as rearranging your furniture or using dog diapers.
To help with early diagnosis, the CCDS Working Group recommends a standardized owner questionnaire (the DISHAA questionnaire), which can be found online. The group advises that veterinarians use this to assess all dogs older than 10, repeating it every six months.
If you think your dog has dementia, it’s a good idea to fill out the questionnaire before seeing a vet and bring it with you to an appointment. Bringing short videos of your pet’s behaviours can also help your provider understand the problem.
Importantly, many other diseases mimic dementia – especially diseases of the brain (such as brain tumours), eye diseases that cause decreased vision, orthopedic diseases, and common endocrine diseases like Cushing’s disease and hypothyroidism. Before concluding that your dog has dementia, vets will typically ask a series of questions about your dog’s signs and do a thorough physical exam.
They might also recommend blood tests, imaging or referral to a specialist for advanced procedures (such as an abdominal ultrasound or an MRI of the brain). Such tests can be costly and time-consuming, and your dog might have other more urgent health concerns that need to be prioritized first. As a result, often a presumptive diagnosis is made based on a slow progression of typical signs and no obvious indicators of other health conditions.
A variety of treatments have been explored to improve quality of life for affected dogs, including anti-anxiety medications, an antidepressant drug called selegiline (also known as L-deprenyl), group training exercises and even fecal transplants (giving your dog an enema of healthy gut bacteria from another dog). There are ongoing clinical trials evaluating other medications, although so far there’s no evidence that any of these reduce the signs of dementia or slow its progression.
Some studies have shown that diets enriched with medium-chain triglycerides, omega-3 fatty acids (especially eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA) and antioxidants might be able to reduce the rate of cognitive decline in dogs. If you’re interested in trying supplements, several commercial “brain health” diets that are enriched with these combinations are now available online or through your vet. Whether nutraceuticals such as omega-3 fatty acids can improve your dog’s brain health when used alone as a supplement needs further study.
While it’s best to talk to your vet if you suspect your dog might have dementia, some of the most effective treatments can be done in your own home and are good for the health of all dogs. Most importantly, look for ways to ensure your dog remains mentally stimulated by providing puzzle toys or toys that dispense food, offering regular physical exercise in varied locations, allowing regular social interactions with familiar people and pets, and trying to teach new tricks.
Yes, it is a good idea to attempt to teach an old dog new tricks, even if you’re not successful.
torontosun.com
Signs of dementia typically appear in senior dogs, or dogs in the last 25 percent of their lifespan.
Author of the article:Washington Post
Washington Post
Jane Sykes
Published Sep 09, 2026 • Last updated 1 day ago • 4 minute read
Closeup photo of an adorable dog.
Photo by SasaStock /Adobe Stock
We independently select everything we recommend. Buying through us may earn us a commission, which supports our work.
While dogs don’t get Alzheimer’s disease, older dogs can develop a strikingly similar condition called canine cognitive dysfunction syndrome – which I’ll refer to as dog dementia from here on, although vets prefer the term CCDS. This is a common, chronic, age-related condition that progresses slowly over time, can’t be attributed to other diseases and has an impact on a dog’s daily life.
Up to 60 percent of dogs older than 8 develop dementia, and a dog’s susceptibility increases by at least 50 percent every year after. Caring for a dog with dementia can be emotionally draining and time-consuming, though there are ways to slow the progression, and you and your pet can still continue enjoying meaningful time together.
Signs of dementia typically appear in senior dogs, or dogs in the last 25 percent of their lifespan. For small dogs (less than 20 pounds), this is about age 8 to 10; for large dogs, signs can begin as early as 6 years old.
While improvements in pet health care can mean longer pet lifespans, it also means you’re more likely to end up caring for a senior pet – one that is at risk for developing dementia.
Just as the Alzheimer’s Association has identified 10 warning signs of early Alzheimer’s in people, a group of veterinary neurologists, behaviourists, and other experts (known as the CCDS Working Group) use the acronym DISHAA to describe six signs that your dog could have dementia. Knowing these signs can help you and your vet identify dementia earlier, so that you can better manage it.
1. Disorientation: Disoriented dogs do things like stare at walls, get stuck in corners or go to the wrong side of the door to be let out.
2. Impaired social interactions: These could include attention-seeking behaviours or decreased interactions with other pets and people, such as not responding to petting or no longer greeting you at the door when you get home from work.
3. Sleep disturbances: Pacing or whining during the night or being difficult to wake during the day.
4. House soiling, learning and memory deficits: Forgetting potty-trained behaviours as well as other commands such as “sit” and “stay,” or pawing at the door to go outside after just being let in.
5. Activity changes such as restlessness, aimless pacing or losing interest in going on walks or playing with toys.
6. Anxiety and fear: Showing signs of irritability, increased aggression or clinging to their owners more than usual.
Early on, dogs with dementia can have signs such as increased sleeping and decreased social interactions that you might think are due to old age. As things progress, problematic issues like house soiling and pacing at night crop up – things that may prompt you to make changes such as rearranging your furniture or using dog diapers.
To help with early diagnosis, the CCDS Working Group recommends a standardized owner questionnaire (the DISHAA questionnaire), which can be found online. The group advises that veterinarians use this to assess all dogs older than 10, repeating it every six months.
If you think your dog has dementia, it’s a good idea to fill out the questionnaire before seeing a vet and bring it with you to an appointment. Bringing short videos of your pet’s behaviours can also help your provider understand the problem.
Importantly, many other diseases mimic dementia – especially diseases of the brain (such as brain tumours), eye diseases that cause decreased vision, orthopedic diseases, and common endocrine diseases like Cushing’s disease and hypothyroidism. Before concluding that your dog has dementia, vets will typically ask a series of questions about your dog’s signs and do a thorough physical exam.
They might also recommend blood tests, imaging or referral to a specialist for advanced procedures (such as an abdominal ultrasound or an MRI of the brain). Such tests can be costly and time-consuming, and your dog might have other more urgent health concerns that need to be prioritized first. As a result, often a presumptive diagnosis is made based on a slow progression of typical signs and no obvious indicators of other health conditions.
A variety of treatments have been explored to improve quality of life for affected dogs, including anti-anxiety medications, an antidepressant drug called selegiline (also known as L-deprenyl), group training exercises and even fecal transplants (giving your dog an enema of healthy gut bacteria from another dog). There are ongoing clinical trials evaluating other medications, although so far there’s no evidence that any of these reduce the signs of dementia or slow its progression.
Some studies have shown that diets enriched with medium-chain triglycerides, omega-3 fatty acids (especially eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA) and antioxidants might be able to reduce the rate of cognitive decline in dogs. If you’re interested in trying supplements, several commercial “brain health” diets that are enriched with these combinations are now available online or through your vet. Whether nutraceuticals such as omega-3 fatty acids can improve your dog’s brain health when used alone as a supplement needs further study.
While it’s best to talk to your vet if you suspect your dog might have dementia, some of the most effective treatments can be done in your own home and are good for the health of all dogs. Most importantly, look for ways to ensure your dog remains mentally stimulated by providing puzzle toys or toys that dispense food, offering regular physical exercise in varied locations, allowing regular social interactions with familiar people and pets, and trying to teach new tricks.
Yes, it is a good idea to attempt to teach an old dog new tricks, even if you’re not successful.
6 signs your dog could have dementia
Signs of dementia typically appear in senior dogs, or dogs in the last 25 percent of their lifespan.
An early sign of dementia may be hiding in your voice, new research suggests
Voice disorders affect roughly 18 million U.S. adults annually and encompass a broader set of problems than you might think.
Author of the article:Washington Post
Washington Post
Erica Sloan, The Washington Post
Published Sep 11, 2026 • 6 minute read
Confident aged hispanic female hold modern smartphone dictate audio message
Photo by Adobe Stock
We independently select everything we recommend. Buying through us may earn us a commission, which supports our work.
Hearing loss and voice disorders – which include abnormalities in vocal quality, pitch or volume – can go hand-in-hand, as you rely on your hearing to modify your tone of voice. Both problems also get more common with age.
Now, new research suggests another connection between the two: Similar to hearing loss, voice problems also may be tied to a higher dementia risk, even in those who have no hearing troubles.
For the study, published in the Journal of Voice, researchers conducted the first large analysis of voice disorders and cognitive decline, using data from primary care visits of more than 833,000 adults aged 50-plus over the course of several years.
People who had been diagnosed with both voice and hearing issues had about double the risk of developing cognitive impairment or dementia, compared with a control group of people with neither diagnosis. Those with a voice disorder and no hearing loss had the second-highest risk versus a control, followed by those with hearing loss alone.
Voice disorders affect roughly 18 million U.S. adults annually and encompass a broader set of problems than you might think.
“Any person who doesn’t have a clear, reasonably loud voice that’s sustainable for as long as [they] need to speak has a voice abnormality,” said senior study author Robert Sataloff, professor and chair of the Department of Otolaryngology–Head & Neck Surgery and a senior associate dean at Drexel University College of Medicine. This could sound strained, choppy, gurgly or shrill, but it also could just involve shifts in pitch that occur suddenly or involuntarily.
A variety of issues can underlie these vocal problems, including nodules, cysts, scars and inflammation caused by, for instance, vocal strain, smoking or acid reflux, Sataloff said. “As we age, we can also lose tissue bulk, nerve endings and respiratory strength, or the power source of the voice,” he added, leading voices to become softer or breathier, or to develop a tremor.
But many people don’t clock these differences as problems to treat, Sataloff said. For example, “you can have a gravelly voice, and not only do people not mind, but sometimes you can make a living out of it,” he pointed out. Consider the actors, singers, sportscasters, radio hosts and politicians known for their rasp. It’s a big reason plenty of voice disorders go untreated, Sataloff said.
In one 2023 survey, as many as 40 percent of people with a voice issue did not seek medical care for it. In the nationally representative sample of 1,522 people, 20 percent of respondents said they had a voice disorder at some point in their lives, and they were more common in certain occupations, such as singer or teacher.
The new study puts forth a powerful reason to pay attention to vocal changes, even if they aren’t affecting your daily life in a dramatic or obvious way.
The researchers first compared people who were diagnosed with a voice disorder (such as dysphonia, which includes a hoarse, strained or otherwise impaired voice; or aphonia, meaning loss of the voice) with a control group of people who saw their primary care doctor for any other reason.
They tracked the doctor visits of both groups over several years, looking for diagnoses of mild cognitive impairment, Alzheimer’s disease or dementia, starting at one year after the initial appointment and stopping at the point of diagnosis or the last recorded visit. Overall, the voice disorder group was about 29 percent more likely to develop a cognitive condition than the control group.
In a second analysis, the researchers wanted to see how much of that effect may actually be driven by hearing loss, given its established link with both voice disorders and a higher dementia risk. So they broke up the voice disorder group into two: those who only had a voice disorder and those who had a voice disorder alongside hearing loss. The combo group had more than double the risk of cognitive trouble compared with a control group with neither condition. Interestingly, the voice-only group still showed a 58 percent greater risk versus a control group with neither issue.
This suggests that voice disorders are independently tied to cognitive decline, regardless of hearing loss, Sataloff said.
However, the voice and hearing groups were compared with different control groups, so it’s hard to know based on this data if one issue poses a greater risk than the other, said Kimberly Mueller, associate professor in the Communication Sciences and Disorders Department at University of Wisconsin at Madison. (Mueller was not involved in the study.)
Another limitation of the study is that it was observational, so it can’t prove that voice disorders cause dementia, only that they are linked with a greater likelihood of developing it. That also means we don’t yet know whether treating a voice disorder will reduce the risk. But there is evidence that treating hearing loss, for instance with hearing aids, can decrease the risk of cognitive decline. It’s possible that resolving a voice problem may have similar benefits.
It isn’t yet known why voice disorders are linked to higher risk of cognitive trouble, but there are a few theories.
One of the strongest has to do with social isolation. “If it’s hard to speak, or you’re straining to be heard, then social interaction becomes a lot of work,” Mueller said. So people with voice disorders are more likely to withdraw from social settings, which is linked to an increased dementia risk.
By speaking less, you also may not activate your brain as much, which could raise dementia risk, said Heather Whitson, director of the Duke Center for the Study of Aging and Human Development, who was not involved in the study. “It’s the idea that if you don’t use it, you lose it.”
A final theory suggests certain biological changes in the brain might drive both voice and cognition issues. “The same things that are affecting the nerves that mediate memory could also affect the nerves that mediate these other neurological functions that relate to your voice or your hearing,” Whitson said.
It’s easy to ignore voice changes. “Sometimes, people will think that a quivering or soft voice is just the effects of aging, and they shouldn’t think that,” Whitson said.
Getting evaluated for voice shifts or difficulties offers an opportunity for care that can make you feel “more confident and comfortable speaking,” Whitson said. This can help with improving quality of life and increasing social engagement, Mueller noted.
People may not realize that there are a wide variety of treatments available, depending on the diagnosis. For issues with vocal cord function, the typical starting point is therapy with a speech-language pathologist who specializes in voice care, Sataloff said. If there’s a structural problem, such as a cyst, it can be removed with a minor surgery, he added. Other simple procedures can help with vocal cords that fail to close (which is necessary to speak).
A workup is also key to rule out other underlying causes, Whitson added. For example, a thyroid problem can cause hoarseness or vocal fatigue, and neurological issues such as Parkinson’s disease, multiple sclerosis and stroke can stifle speech.
In any case, the study suggests that voice problems may be a clue into future brain health – one that doctors could use to find and track people at higher risk of dementia earlier in life. “When health care providers see somebody with hearing loss, they think about cognitive assessment,” Sataloff said. “Now, when they see people with voices that don’t sound right, they should also be thinking of cognitive assessment.”
healthing.ca
torontosun.com
Voice disorders affect roughly 18 million U.S. adults annually and encompass a broader set of problems than you might think.
Author of the article:Washington Post
Washington Post
Erica Sloan, The Washington Post
Published Sep 11, 2026 • 6 minute read
Confident aged hispanic female hold modern smartphone dictate audio message
Photo by Adobe Stock
We independently select everything we recommend. Buying through us may earn us a commission, which supports our work.
Hearing loss and voice disorders – which include abnormalities in vocal quality, pitch or volume – can go hand-in-hand, as you rely on your hearing to modify your tone of voice. Both problems also get more common with age.
Now, new research suggests another connection between the two: Similar to hearing loss, voice problems also may be tied to a higher dementia risk, even in those who have no hearing troubles.
For the study, published in the Journal of Voice, researchers conducted the first large analysis of voice disorders and cognitive decline, using data from primary care visits of more than 833,000 adults aged 50-plus over the course of several years.
People who had been diagnosed with both voice and hearing issues had about double the risk of developing cognitive impairment or dementia, compared with a control group of people with neither diagnosis. Those with a voice disorder and no hearing loss had the second-highest risk versus a control, followed by those with hearing loss alone.
Voice disorders affect roughly 18 million U.S. adults annually and encompass a broader set of problems than you might think.
“Any person who doesn’t have a clear, reasonably loud voice that’s sustainable for as long as [they] need to speak has a voice abnormality,” said senior study author Robert Sataloff, professor and chair of the Department of Otolaryngology–Head & Neck Surgery and a senior associate dean at Drexel University College of Medicine. This could sound strained, choppy, gurgly or shrill, but it also could just involve shifts in pitch that occur suddenly or involuntarily.
A variety of issues can underlie these vocal problems, including nodules, cysts, scars and inflammation caused by, for instance, vocal strain, smoking or acid reflux, Sataloff said. “As we age, we can also lose tissue bulk, nerve endings and respiratory strength, or the power source of the voice,” he added, leading voices to become softer or breathier, or to develop a tremor.
But many people don’t clock these differences as problems to treat, Sataloff said. For example, “you can have a gravelly voice, and not only do people not mind, but sometimes you can make a living out of it,” he pointed out. Consider the actors, singers, sportscasters, radio hosts and politicians known for their rasp. It’s a big reason plenty of voice disorders go untreated, Sataloff said.
In one 2023 survey, as many as 40 percent of people with a voice issue did not seek medical care for it. In the nationally representative sample of 1,522 people, 20 percent of respondents said they had a voice disorder at some point in their lives, and they were more common in certain occupations, such as singer or teacher.
The new study puts forth a powerful reason to pay attention to vocal changes, even if they aren’t affecting your daily life in a dramatic or obvious way.
The researchers first compared people who were diagnosed with a voice disorder (such as dysphonia, which includes a hoarse, strained or otherwise impaired voice; or aphonia, meaning loss of the voice) with a control group of people who saw their primary care doctor for any other reason.
They tracked the doctor visits of both groups over several years, looking for diagnoses of mild cognitive impairment, Alzheimer’s disease or dementia, starting at one year after the initial appointment and stopping at the point of diagnosis or the last recorded visit. Overall, the voice disorder group was about 29 percent more likely to develop a cognitive condition than the control group.
In a second analysis, the researchers wanted to see how much of that effect may actually be driven by hearing loss, given its established link with both voice disorders and a higher dementia risk. So they broke up the voice disorder group into two: those who only had a voice disorder and those who had a voice disorder alongside hearing loss. The combo group had more than double the risk of cognitive trouble compared with a control group with neither condition. Interestingly, the voice-only group still showed a 58 percent greater risk versus a control group with neither issue.
This suggests that voice disorders are independently tied to cognitive decline, regardless of hearing loss, Sataloff said.
However, the voice and hearing groups were compared with different control groups, so it’s hard to know based on this data if one issue poses a greater risk than the other, said Kimberly Mueller, associate professor in the Communication Sciences and Disorders Department at University of Wisconsin at Madison. (Mueller was not involved in the study.)
Another limitation of the study is that it was observational, so it can’t prove that voice disorders cause dementia, only that they are linked with a greater likelihood of developing it. That also means we don’t yet know whether treating a voice disorder will reduce the risk. But there is evidence that treating hearing loss, for instance with hearing aids, can decrease the risk of cognitive decline. It’s possible that resolving a voice problem may have similar benefits.
It isn’t yet known why voice disorders are linked to higher risk of cognitive trouble, but there are a few theories.
One of the strongest has to do with social isolation. “If it’s hard to speak, or you’re straining to be heard, then social interaction becomes a lot of work,” Mueller said. So people with voice disorders are more likely to withdraw from social settings, which is linked to an increased dementia risk.
By speaking less, you also may not activate your brain as much, which could raise dementia risk, said Heather Whitson, director of the Duke Center for the Study of Aging and Human Development, who was not involved in the study. “It’s the idea that if you don’t use it, you lose it.”
A final theory suggests certain biological changes in the brain might drive both voice and cognition issues. “The same things that are affecting the nerves that mediate memory could also affect the nerves that mediate these other neurological functions that relate to your voice or your hearing,” Whitson said.
It’s easy to ignore voice changes. “Sometimes, people will think that a quivering or soft voice is just the effects of aging, and they shouldn’t think that,” Whitson said.
Getting evaluated for voice shifts or difficulties offers an opportunity for care that can make you feel “more confident and comfortable speaking,” Whitson said. This can help with improving quality of life and increasing social engagement, Mueller noted.
People may not realize that there are a wide variety of treatments available, depending on the diagnosis. For issues with vocal cord function, the typical starting point is therapy with a speech-language pathologist who specializes in voice care, Sataloff said. If there’s a structural problem, such as a cyst, it can be removed with a minor surgery, he added. Other simple procedures can help with vocal cords that fail to close (which is necessary to speak).
A workup is also key to rule out other underlying causes, Whitson added. For example, a thyroid problem can cause hoarseness or vocal fatigue, and neurological issues such as Parkinson’s disease, multiple sclerosis and stroke can stifle speech.
In any case, the study suggests that voice problems may be a clue into future brain health – one that doctors could use to find and track people at higher risk of dementia earlier in life. “When health care providers see somebody with hearing loss, they think about cognitive assessment,” Sataloff said. “Now, when they see people with voices that don’t sound right, they should also be thinking of cognitive assessment.”
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An early sign of dementia may be hiding in your voice, new research suggests
Voice disorders affect roughly 18 million U.S. adults annually and encompass a broader set of problems than you might think.
The dementia that often strikes in midlife — and the signs people miss
Experts explain why FTD tends to hit earlier in life than other dementias, the often-overlooked signs to know and what care for people with the condition looks like.
Author of the article:Washington Post
Washington Post
Erica Sloan, The Washington Post
Published Sep 25, 2026 • Last updated 1 day ago • 6 minute read
frontal lobe atrophy on MRI film probably Frontotemporal Dementia
Photo by Atthapon /Adobe Stock
If you’ve heard of frontotemporal dementia (FTD), it may be because of Bruce Willis or Wendy Williams – two celebrities whose diagnoses in recent years have shed light on this infrequently discussed neurodegenerative disease. Though FTD is relatively rare, accounting for about 5 percent to 10 percent of all dementia cases and affecting an estimated 50,000 to 60,000 people in the United States, it’s the most common form of early-onset dementia.
In fact, 60 percent of people who get diagnosed with it are ages 45 to 64, decades younger than the average person diagnosed with Alzheimer’s disease (which causes most cases of dementia). And yet, experts believe this is a significant undercount because it’s “rare enough that most medical providers, even specialists, don’t have experience with it, and so they don’t know what it looks like,” said Brad Dickerson, neurologist at the Mass General Brigham Neuroscience Institute and director of the Frontotemporal Disorders Unit at Massachusetts General Hospital.
The initial symptoms of FTD also diverge sharply from those of the more common Alzheimer’s disease because of the parts of the brain it attacks. FTD often starts “in the front of the brain, which is very important for behaviour, regulation of social interactions, addiction, drive, organizing and planning,” said Bruce Miller, a professor of neurology and director of the Edward and Pearl Fein Memory and Aging Center at the University of California at San Francisco.
So, FTD generally manifests first with behaviour or mood changes – rather than the memory loss and thinking problems of Alzheimer’s (which typically first affects the areas of the brain responsible for these tasks, including the hippocampus). It’s the reason FTD is often misread as a psychiatric issue, Miller said. On average, it takes about three to four years for people to get a diagnosis of FTD, according to the Association for Frontotemporal Degeneration.
Below, experts explain why FTD tends to hit earlier in life than other dementias, the often-overlooked signs to know and what care for people with the condition looks like.
Unlike Alzheimer’s, most people with FTD are diagnosed before age 65. The question of why is still being studied – but experts think the answer has to do with the underlying cause.
Roughly 20 percent of cases are thought to be caused by any one of several genetic mutations. Two of them produce abnormal proteins with toxic effects on brain cells, and one of them leads to a deficiency in a protein that neurons need, Dickerson explained. These are readily passed down: You only need one bad copy of any of these genes to almost certainly develop FTD, he said, meaning that a child of a person with a mutation has a 50 percent chance of inheriting it.
Genetic mutations can “drive the biology” of FTD, starting early in life, Miller said. “By the time someone reaches the age of 40 or 50, there may have been many years [during which] that genetic cause has wreaked havoc in their brain.”
Experts also think yet-to-be-discovered genes could play a role in some of the remaining 80 percent of cases. After all, as many as 40 percent of people with FTD have a family history.
One area of research is focused on genetic variants that, individually, are not disease-causing abnormalities, Dickerson said, but that could increase risk when they occur together. It’s thought that if you inherit particular sets of these genes, you could be made more vulnerable by other risk factors, perhaps environmental ones, than someone without a similar genetic pattern. (It’s not clear what these environmental factors might be yet, but Dickerson made the comparison to the known association between air pollution and an increased likelihood of developing Alzheimer’s and the fact that not everyone who lives in a polluted area will develop the disease.)
Ultimately, Miller said, the “number of FTD cases that have a genetic basis is likely quite high,” which pushes down the age of onset. As for the cases where a genetic link isn’t apparent, experts are still figuring out the contributors, though lifestyle is thought to be important. Research suggests that even those with a genetic mutation tied to FTD could delay symptoms if they are cognitively active and exercise regularly, Miller said. He added that head trauma is a risk factor that researchers are investigating, too.
The symptoms of FTD depend on where exactly in the brain the condition starts. If it initially hits the temporal lobe, particularly on the left side, it’ll affect language skills, including the ability to speak and comprehend – causing a condition known as primary progressive aphasia. With this kind of FTD, people tend to get referred to a neurologist and diagnosed quickly, Dickerson said.
But as noted above, FTD most often begins in the frontal lobe and its earliest symptoms typically include behaviour or personality changes – called behavioural-variant FTD. The most common ones are easily mistaken as signs of psychiatric conditions such as depression or bipolar disorder, or dismissed as the effects of stress, burnout or even a midlife crisis. They include:
Loved ones and friends often notice these changes first. A person with FTD will generally lack insight into their symptoms and might not think anything is wrong, Dickerson said. They might relay a different story to a doctor, which can further complicate diagnosis.
The stigma surrounding both dementia and psychiatric conditions can also lead people with FTD and their family members to avoid seeking care. If they do, they often wind up getting referred to a psychiatrist, Dickerson said, rather than a neurologist.
By the time a diagnosis arrives, the disease has often progressed. “FTD moves about twice as fast as the typical Alzheimer’s disease,” Miller said, with an average life expectancy around seven to 13 years. “As the disease progresses, the apathy becomes more profound, and people completely immobilize,” he said. Some people develop motor problems, such as tremors; as many as 30 percent of those with FTD wind up with symptoms consistent with amyotrophic lateral sclerosis (ALS), a motor neuron disease that causes weakness, muscle wasting and difficulty swallowing.
It’s the reason Miller said it’s important to “think about the brain, and the frontal lobes in particular, in any case of dramatic change in behaviour or personality.”
A helpful point to remember: Dementia is often understood as a loss, for instance, of memory or reasoning skills, and there can certainly be a loss of organization with FTD. But many early symptoms of FTD also reflect “a gain of personality traits that were not there before,” Dickerson said. Ones that register as inappropriate or out of character should especially prompt a visit to a neurologist. “We can help families manage it if we get in early,” Miller said.
There is currently no cure for FTD. Care involves working with a team of experts – physicians, nurses, psychologists – to manage symptoms and behaviours, Miller said. “That often means thinking about, ‘Which ones of these [symptoms] need to be managed, and which can we ignore?'” Some may be harmful to the person with FTD and those around them, while others may be minor enough to learn to accept and work around.
Some people with FTD may benefit from the antidepressants known as selective serotonin reuptake inhibitors (SSRIs), Miller noted. “They can decrease irritability and compulsive behaviours and improve mood.” Those who have language deficits may also find speech therapy to be helpful, at least in early stages.
Both experts are hopeful, however, about the momentum they’re seeing in treatment research, which has been supported by growing awareness. Dickerson pointed to clinical trials that aim to restore levels of the deficient protein in one form of FTD. Miller noted studies attempting to lower tau – one of the abnormal proteins that can drive FTD – and gene-editing efforts to “turn off or turn down the bad genes” in other types of dementia. These approaches are “not quite ready yet for frontotemporal dementia,” but when they are, “it’s going to be really exciting.”
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torontosun.com
Experts explain why FTD tends to hit earlier in life than other dementias, the often-overlooked signs to know and what care for people with the condition looks like.
Author of the article:Washington Post
Washington Post
Erica Sloan, The Washington Post
Published Sep 25, 2026 • Last updated 1 day ago • 6 minute read
frontal lobe atrophy on MRI film probably Frontotemporal Dementia
Photo by Atthapon /Adobe Stock
If you’ve heard of frontotemporal dementia (FTD), it may be because of Bruce Willis or Wendy Williams – two celebrities whose diagnoses in recent years have shed light on this infrequently discussed neurodegenerative disease. Though FTD is relatively rare, accounting for about 5 percent to 10 percent of all dementia cases and affecting an estimated 50,000 to 60,000 people in the United States, it’s the most common form of early-onset dementia.
In fact, 60 percent of people who get diagnosed with it are ages 45 to 64, decades younger than the average person diagnosed with Alzheimer’s disease (which causes most cases of dementia). And yet, experts believe this is a significant undercount because it’s “rare enough that most medical providers, even specialists, don’t have experience with it, and so they don’t know what it looks like,” said Brad Dickerson, neurologist at the Mass General Brigham Neuroscience Institute and director of the Frontotemporal Disorders Unit at Massachusetts General Hospital.
The initial symptoms of FTD also diverge sharply from those of the more common Alzheimer’s disease because of the parts of the brain it attacks. FTD often starts “in the front of the brain, which is very important for behaviour, regulation of social interactions, addiction, drive, organizing and planning,” said Bruce Miller, a professor of neurology and director of the Edward and Pearl Fein Memory and Aging Center at the University of California at San Francisco.
So, FTD generally manifests first with behaviour or mood changes – rather than the memory loss and thinking problems of Alzheimer’s (which typically first affects the areas of the brain responsible for these tasks, including the hippocampus). It’s the reason FTD is often misread as a psychiatric issue, Miller said. On average, it takes about three to four years for people to get a diagnosis of FTD, according to the Association for Frontotemporal Degeneration.
Below, experts explain why FTD tends to hit earlier in life than other dementias, the often-overlooked signs to know and what care for people with the condition looks like.
Unlike Alzheimer’s, most people with FTD are diagnosed before age 65. The question of why is still being studied – but experts think the answer has to do with the underlying cause.
Roughly 20 percent of cases are thought to be caused by any one of several genetic mutations. Two of them produce abnormal proteins with toxic effects on brain cells, and one of them leads to a deficiency in a protein that neurons need, Dickerson explained. These are readily passed down: You only need one bad copy of any of these genes to almost certainly develop FTD, he said, meaning that a child of a person with a mutation has a 50 percent chance of inheriting it.
Genetic mutations can “drive the biology” of FTD, starting early in life, Miller said. “By the time someone reaches the age of 40 or 50, there may have been many years [during which] that genetic cause has wreaked havoc in their brain.”
Experts also think yet-to-be-discovered genes could play a role in some of the remaining 80 percent of cases. After all, as many as 40 percent of people with FTD have a family history.
One area of research is focused on genetic variants that, individually, are not disease-causing abnormalities, Dickerson said, but that could increase risk when they occur together. It’s thought that if you inherit particular sets of these genes, you could be made more vulnerable by other risk factors, perhaps environmental ones, than someone without a similar genetic pattern. (It’s not clear what these environmental factors might be yet, but Dickerson made the comparison to the known association between air pollution and an increased likelihood of developing Alzheimer’s and the fact that not everyone who lives in a polluted area will develop the disease.)
Ultimately, Miller said, the “number of FTD cases that have a genetic basis is likely quite high,” which pushes down the age of onset. As for the cases where a genetic link isn’t apparent, experts are still figuring out the contributors, though lifestyle is thought to be important. Research suggests that even those with a genetic mutation tied to FTD could delay symptoms if they are cognitively active and exercise regularly, Miller said. He added that head trauma is a risk factor that researchers are investigating, too.
The symptoms of FTD depend on where exactly in the brain the condition starts. If it initially hits the temporal lobe, particularly on the left side, it’ll affect language skills, including the ability to speak and comprehend – causing a condition known as primary progressive aphasia. With this kind of FTD, people tend to get referred to a neurologist and diagnosed quickly, Dickerson said.
But as noted above, FTD most often begins in the frontal lobe and its earliest symptoms typically include behaviour or personality changes – called behavioural-variant FTD. The most common ones are easily mistaken as signs of psychiatric conditions such as depression or bipolar disorder, or dismissed as the effects of stress, burnout or even a midlife crisis. They include:
Loved ones and friends often notice these changes first. A person with FTD will generally lack insight into their symptoms and might not think anything is wrong, Dickerson said. They might relay a different story to a doctor, which can further complicate diagnosis.
The stigma surrounding both dementia and psychiatric conditions can also lead people with FTD and their family members to avoid seeking care. If they do, they often wind up getting referred to a psychiatrist, Dickerson said, rather than a neurologist.
By the time a diagnosis arrives, the disease has often progressed. “FTD moves about twice as fast as the typical Alzheimer’s disease,” Miller said, with an average life expectancy around seven to 13 years. “As the disease progresses, the apathy becomes more profound, and people completely immobilize,” he said. Some people develop motor problems, such as tremors; as many as 30 percent of those with FTD wind up with symptoms consistent with amyotrophic lateral sclerosis (ALS), a motor neuron disease that causes weakness, muscle wasting and difficulty swallowing.
It’s the reason Miller said it’s important to “think about the brain, and the frontal lobes in particular, in any case of dramatic change in behaviour or personality.”
A helpful point to remember: Dementia is often understood as a loss, for instance, of memory or reasoning skills, and there can certainly be a loss of organization with FTD. But many early symptoms of FTD also reflect “a gain of personality traits that were not there before,” Dickerson said. Ones that register as inappropriate or out of character should especially prompt a visit to a neurologist. “We can help families manage it if we get in early,” Miller said.
There is currently no cure for FTD. Care involves working with a team of experts – physicians, nurses, psychologists – to manage symptoms and behaviours, Miller said. “That often means thinking about, ‘Which ones of these [symptoms] need to be managed, and which can we ignore?'” Some may be harmful to the person with FTD and those around them, while others may be minor enough to learn to accept and work around.
Some people with FTD may benefit from the antidepressants known as selective serotonin reuptake inhibitors (SSRIs), Miller noted. “They can decrease irritability and compulsive behaviours and improve mood.” Those who have language deficits may also find speech therapy to be helpful, at least in early stages.
Both experts are hopeful, however, about the momentum they’re seeing in treatment research, which has been supported by growing awareness. Dickerson pointed to clinical trials that aim to restore levels of the deficient protein in one form of FTD. Miller noted studies attempting to lower tau – one of the abnormal proteins that can drive FTD – and gene-editing efforts to “turn off or turn down the bad genes” in other types of dementia. These approaches are “not quite ready yet for frontotemporal dementia,” but when they are, “it’s going to be really exciting.”
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The initial symptoms of FTD also diverge sharply from those of the more common Alzheimer's disease.