AFTD volunteer Wanda Smith highlighted the differences between FTD and Alzheimer’s disease in a recent article published by the San Diego Union-Tribune, sharing her experiences as a care partner for her mother, Sara Bridges, to illustrate how the diseases differ.

Smith told the Tribune that one of the strongest initial signs she got that something was wrong came on Thanksgiving 1982. While the family cleaned up after eating, Bridges told Smith and her siblings, “I’m so disappointed in you children; I cannot believe that you’re not helping me get the Thanksgiving meal on the table.”

After Bridges was diagnosed with Alzheimer’s, Smith assumed the role of her care partner, supporting her mother over the following years. Wanda reflected that at one point, she was caring for her mother while raising her toddler and infant, all under the same roof, noting that each required similar levels of care.

After Bridges died in 1987, Smith thought she knew what the results of the subsequent autopsy would be. However, Bridges lacked the abnormal clusters of beta-amyloid protein fragments and tau tangles that indicate Alzheimer’s.

“She’d been diagnosed with Alzheimer’s all this time, and they were surprised because the thing with Alzheimer’s is plaques and tangles,” Smith told the Tribune. “She had looked like an Alzheimer’s [patient]; she behaved like it was Alzheimer’s, but it wasn’t, and so that was the beginning of the journey.”

That journey would lead to Smith’s family submitting their DNA for genetic testing and the discovery of the likely cause of Bridges’ disease: a mutation in the progranulin (GRN) gene, a known genetic cause of FTD. In addition to the general lack of awareness of FTD, misdiagnoses like Bridges’ are common because the symptomology of FTD overlaps with various psychiatric disorders and Alzheimer’s disease. While memory loss isn’t a hallmark feature of FTD, for example, it can still develop in persons with the disease.

As AFTD CEO Susan L-J Dickinson notes in the article, the variety of symptoms and their onset differs depending on which brain regions are affected first and how FTD progresses through other brain areas. Symptoms of FTD can include emotional difficulties, problems with communication, apathetic attitudes toward previous hobbies or talents, and disinhibited behavior, among others.

“It’s confusing, right? The first thing you think of is not that this person has a medical condition and they need help,” Dickinson said. “You think, ‘Wow, what’s going on here? I thought I knew you; I can’t rely on you anymore.’”

Another crucial difference the article highlights between FTD and Alzheimer’s is the former’s tendency to develop earlier in life – FTD is the most common dementia under age 60. Often, FTD strikes while people are raising a family and managing a career, which can lead to an earlier retirement than what may have been planned.

As the article emphasizes, there are key differences between FTD and Alzheimer’s. Not only does FTD strike younger and have different symptoms, but it is misdiagnosed more frequently.

Of those diagnosed with FTD, 40% have what is known as familial FTD, meaning they have a family history of one or more blood relatives diagnosed with FTD or a related condition like ALS. For a subset of those affected by familial FTD, a disease-causing genetic mutation can be identified as the cause, such as Sara Bridges’ GRN mutation.