This mental problem can help predict dementia years before memory loss

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Frontotemporal dementia is a big cause of dementia among younger people. It is often diagnosed between the ages of 45 and 65.

It changes behavior, language, and personality, leading to impulsivity, socially inappropriate behavior, and repetitive or compulsive behaviors.

In a recent study published in Alzheimer’s & Dementia, researchers found that apathy—a lack of interest or motivation—could predict front-temporal dementia many years before symptoms start, offering a ‘window of opportunity’ to treat the disease at an early stage.

The research was from the University of Cambridge and elsewhere. One author is Professor James Rowe.

A common feature of frontotemporal dementia is apathy, with a loss of motivation, initiative, and interest in things. It is not depression or laziness, but it can be mistaken for them.

Brain scanning studies found that in people with frontotemporal dementia it is caused by shrinkage in special parts at the front of the brain—and the more severe the shrinkage, the worse the apathy.

In the study, the team used data from the Genetic Frontotemporal dementia Initiative (GENFI). Over 1,000 people are taking part in GENFI, from families where there is a genetic cause of Frontotemporal dementia.

The team tested 304 healthy people who carry a faulty gene that causes frontotemporal dementia, and 296 of their relatives who have normal genes.

The participants were followed over several years. The researchers looked for changes in apathy, memory tests, and MRI scans of the brain.

They found people with the genetic mutations had more apathy than other members of their family, which over two years increased much more than in people with normal genetics.

The apathy predicted cognitive decline, and this accelerated as they approached the estimated age of onset of symptoms.

The finding showed apathy progresses much faster for those people who are at greater risk of developing frontotemporal dementia, and this is linked to greater atrophy in the brain.

The study highlights the importance of examining why someone has apathy.

There are many reasons why someone feels apathetic. It may well be easy to treat a medical condition, such as low levels of thyroid hormone, or a psychiatric illness such as depression.

But doctors need to keep in mind the possibility of apathy heralding dementia, and increasing the chance of dementia if left unaddressed, particularly if someone has a family history of dementia.

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