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Dementia: Making rude comments could be a warning sign – what to look for

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Dementia is an umbrella term for clusters of symptoms associated with brain damage that get worse over time. The type of symptoms you experience first will depend on the region of the brain affected. Frontotemporal dementia (FTD), for example, causes problems with behaviour and language first because it affects the areas of the brain responsible for these functions.

The first noticeable FTD symptoms are changes to personality and behaviour.

According to the Alzheimer’s Society (AS), these changes may take the form of a loss of inhibitions.

“For example, making insensitive or rude comments about someone’s appearance, making sexual gestures in public, staring at strangers, or being verbally or physically aggressive,” explains the AS.

Other behavioural changes include:

  • Neglecting personal hygiene
  • Overeating
  • Loss of motivation.

“FTD can also affect how sensitive a person is to physical or environmental stimulation such as temperature, sounds and even pain,” adds the AS.

How to respond

According to the NHS, you should see a GP if you think you have early symptoms of dementia.

“If you’re worried about someone else, encourage them to make an appointment with a GP and perhaps suggest you go with them,” advises the health body.

It adds: “The GP can do some simple checks to try to find the cause of your symptoms, and they can refer you to a memory clinic or another specialist for further tests if needed.”

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Am I at risk?

Frontotemporal dementia is caused by clumps of abnormal protein forming inside brain cells.

It is not fully understood what causes this, but research has uncovered a genetic link.

“For behavioural variant FTD, one in every two or three people with the disease could have a family history,” explains Alzheimer’s Research UK.

According to the charity, scientists have found a number of faulty genes that can cause inherited forms of FTD, including tau, progranulin and C9ORF72.

“If your doctor suspects a strong family link, you may be offered a genetic test and close relatives may be offered genetic counselling,” it adds.

In cases of FTD where there is no family history, the risk factors are not yet fully understood but some progress has been made.

One study sought to determine whether smoking and obesity could be risk factors for FTD and Alzheimer’s disease (AD).

Ninety patients with FTD and 654 patients with AD were compared with 116 cognitively healthy elderly individuals in a longitudinal design with 15 to 31 years between measurements of risk factors before the dementia diagnosis.

There were no associations between smoking and FTD but there were significant associations between obesity and FTD.

Losing weight may therefore lower your risk of brain decline, although the research is not conclusive.

“The best way to treat obesity is to eat a healthy reduced-calorie diet and exercise regularly,” says the NHS.

To do this, you should:

  • Eat a balanced calorie-controlled diet as recommended by a GP or weight loss management health professional (such as a dietitian)
  • Join a local weight loss group
  • Take up activities such as fast walking, jogging, swimming or tennis for 150 to 300 minutes (2.5 to five hours) a week
  • Eat slowly and avoid situations where you know you could be tempted to overeat.

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