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FEATURE:
IN REAL TIME

IN REAL TIME part 3

Fronto Temporal Dementia
To Treat or Not to Treat

By Rajam Ramamurthy, MD

“Dementia” is not a specific disease: It is a catchall term that de- functions must be significantly impaired to consider dementia:
scribes a wide range of symptomatology. Alzheimer’s disease ac- • Memory
counts for 60 to 80 percent of all dementia. Vascular dementia, • Communication and language
which occurs after a stroke, is the second most common dementia • Ability to focus and pay attention
type and is on the decline in the US due to the efforts in stroke pre- • Reasoning and judgment
vention. Other conditions that can cause symptoms of dementia in- • Visual perception
clude thyroid problems and vitamin deficiencies, and are reversible.
‘Senile Dementia’ is an archaic term that implies that serious mental Data from both the Centers for Disease Control and the National
decline is a normal part of aging. Recently I was pleasantly surprised Institutes of Health indicate increasing prevalence of Alzheimer’s.
to hear from my honorary Uncle Sheth, who was a friend and class- Starting at age 65, the risk of developing the disease doubles every
mate of my father. If my father had lived, he would be 100 years 5 years. By age 85 between 25% and 50% of people will exhibit
old this year, but he died at age 84 and his mental status was clear signs of Alzheimer’s disease. As many as 5.3 million Americans cur-
as crystal. Uncle Sheth, who is alive at 96, still is. Forgetfulness, rently have Alzheimer’s disease. By 2050, the number is expected to
which I do believe increases past age 60, must be differentiated from more than double. Alzheimer’s is the sixth leading cause of death
dementia. in the United States and is the fifth leading cause among persons
age 65 and older. Frontotemporal dementia (FTD) comprises about
The literature states that at least two of the following core mental

28 San Antonio Medicine • October 2016