- Frontotemporal dementia is a neurodegenerative condition that tends to strike people between the ages of 45 and 65.
- Researchers say lifestyle changes can reduce a younger adult’s risk of getting this disease.
- Experts recommend moderate physical exercise, mental games such as puzzles, and quality sleep.
It’s not Alzheimer’s disease, but it causes dementia.
Frontotemporal lobar degeneration (FTLD) strikes in the prime of life, generally between the ages of 45 and 65.
Also known as frontotemporal dementia (FTD), it’s a neurodegenerative condition that affects personality, language, movement, and the ability to make decisions.
Rapid cognitive and physical decline can lead to death in under a decade.
However, a new study published in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association may give new hope to those who carry the genetic mutation that causes FTD.
Researchers say a systemic review revealed that physically and cognitively demanding lifestyles are associated with better brain health in relation to aging and Alzheimer’s disease.
The researchers noted the lack of studies on how lifestyle affects people with FTD.
Their recent findings suggest that those with a genetic predisposition for the condition can take action that may help.
The study involved 105 people who carry the genetic mutation that causes FTD.
All were either asymptomatic or had mild, early-stage symptoms.
Also included were 69 people who did not carry the genetic mutation.
Participants took a series of cognitive and memory tests. They were questioned about current levels of mental and physical activity. That included such things as socializing, reading, and walking.
MRIs of the brain were used to assess the degree of brain degeneration.
Follow-up MRI scans one year into the study showed that lifestyle did not have a significant impact on brain degeneration due to FTD.
However, those who were most mentally and physically active did twice as well on cognitive tests than those who were least active.
Genetic mutation carriers who had more active lifestyles were found to have more than 55 percent slower decline per year.
Dr. Rawan Tarawneh is a cognitive neurologist and assistant professor of neurology at The Ohio State University Wexner Medical Center.
She finds the study convincing.
“It’s fascinating because we’ve seen the role of physical activity in maintaining brain health in Alzheimer’s disease and vascular dementia. There hasn’t been another study of this size and meticulous analysis in FTD,” Tarawneh told Healthcare Website.
“It was well-designed, had a well-characterized cohort, and strong data. It covers a major gap in the field right now,” she added. “It’s timely with our focus on physical health and mindfulness and mental exercise, particularly for people who have mutations that increase risk for conditions like FTD.”
The study suggests that living an active lifestyle is associated with less functional decline.
That’s crucial because treatment options are limited.
Dr. David A. Merrill, PhD, is a neurologist and geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, California.
He told Healthcare Website the study is remarkable in that it involved verified cases of genetically driven FTD.
“Those people, if they live long enough, will definitely develop the syndrome. The really sad part is there’s no prescription medication and no known effective therapies for FTD. That leaves patients, families, and clinicians without effective options,” said Merrill.
That more active people outperformed what brain scans would have predicted, based on the amount of atrophy, is “mind blowing,” he said.
FTD isn’t as common as Alzheimer’s disease as a cause of dementia, and the symptoms aren’t quite the same.
“Someone just beginning to show signs of Alzheimer’s disease might have prominent, rapid forgetfulness. Early FTD involves more language or behavior. It can be confusing for patients and loved ones when someone has a really strong memory but behaviors or language are impaired,” said Merrill.
“The researchers show evidence that even in the face of a genetic degeneration disorder you can have a positive impact on cognitive function. ‘Use it or lose it’ applies even in the case of genetically driven dementia,” he added.
According to Merrill, lifestyle is more powerful than any medicine for FTD. And it’s never too late to make changes.
For brain exercise, Merrill suggests a variety of stimulating activities such as puzzles, learning a new language or musical instrument, and engaging in conversation.
He recommends spending 30 minutes a day or more on these types of enriching activities.
For physical exercise, he points to the American Heart Association’s recommendations of 150 minutes per week of moderate-intensity aerobic activity plus weight training 2 days a week.
He cautions against overtraining to avoid injury and exhaustion.
“We know that cortisol is toxic for the brain at high levels, so stress reduction is also important,” said Merrill.
To help reduce stress, he recommends activities such as hiking, yoga, and tai chi as opposed to competitive athletics.
It’s also important to get enough quality sleep.
Merrill was involved in a previous study at the University of California, Los Angeles showing that exercise and higher adherence to a Mediterranean style diet can affect brain structure and degeneration.
“We can absolutely say both physical and mental activity is good not just for primary prevention, but for people who have this condition to prevent or slow down progression,” said Merrill.
Study authors acknowledge that although their research shows correlation, it does not prove that lifestyle changes can alter the course of FTD.
That’s something that must be determined through additional research.
Study participants will continue to be followed. The researchers anticipate bigger differences between the more active and less active groups.
Clinical trials are taking place at the University of California, San Francisco Memory and Aging Center and at other institutions.
At the Pacific Brain Health Center, Merrill is currently involved in a prevention trial that combines cognitive fitness training with aerobics to maximize the benefits of both. Enrollment is ongoing.
Tarawneh has concerns that the benefit of lifestyle modification may be somewhat overestimated.
“I don’t underestimate the value of this study. It’s very relevant, but this is not a cure. It’s a safe, easy prevention strategy we recommend to all our patients for overall brain health. It will be more helpful for people who don’t yet have symptoms and may delay onset or slow the rate of decline,” she explained.
“Ideally, we would like to have lifestyle modification as part of a bigger picture treatment plan that also involves medications that target underlying disease pathology,” said Tarawneh.