Halifax Courier

A rare form of dementia that affects under 65s

- By Dr Keith Souter

The family of Bruce Willis the actor best known for his Die Hard movies, who was recently diagnosed with frontotemp­oral dementia, hope that his diagnosis will bring attention to this rare form of dementia.

I researched it and the other varieties of dementia quite extensivel­y a few years ago when I was writing my book Understand­ing Dementia.

This condition causes only two per cent of all new cases of dementia in the UK.

The two areas of the brain that are mainly affected by this condition have major functions in shaping our personalit­ies, so behavioura­l disorders and personalit­y changes may be seen in this dementia.

This condition can be extremely difficult to diagnose, because it often occurs at an earlier age than other dementias. Whereas most dementias occur after the age of 65 years, frontotemp­oral dementia tends to start between the ages of 45 and 65 years.

There are two frontal lobes of the brain, both of which are situated at the front behind the forehead. These are where reasoning, calculatio­n, problem solving and judgement take place. Thus, they are command areas of the brain for behaviour. Broca’s area, a part of the brain which controls speech, is usually in the frontal lobe.

The temporal lobes are found at the sides of the brain. These are mainly concerned with memory, although are also associated with emotions and speech. Wernicke’s area, which controls language recognitio­n, is usually located in the left hemisphere.

When these important parts of the brain suffer from nerve cell damage and loss of cells, the lobes shrink and the functions associated with them gradually deteriorat­e.

There are actually several variants of fronto-temporal dementia that can be seen. The type that Bruce Willis is suffering from seems to be progressiv­e non-fluent aphasia where speech fluency is particular­ly affected. A most distressin­g symptom for an actor.

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