What Happens in the Brain
How frontotemporal dementia affects the brain and changes behaviour and emotions
For many families, the behavioural changes in frontotemporal dementia can feel deeply confusing. The person may still look physically healthy. They may speak normally. They may remember many things from the past. Yet something important has changed.
To understand why this happens, it can be helpful to look briefly at what is happening in the brain.
The Frontal Lobes - The Brain’s Control System
The frontal lobes are located behind the forehead and play a central role in many of the functions that shape our behaviour and personality. They help us regulate impulses, understand social situations, plan and organise actions, control emotional reactions, and show empathy toward others.
You can think of the frontal lobes as part of the brain’s regulation system. They help us pause before acting. They help us interpret other people’s reactions. They help us adapt our behaviour to different situations.
The Temporal Lobes - Understanding Meaning and Emotion
The temporal lobes are located on the sides of the brain. These areas are important for language, emotional processing, recognising people, and understanding meaning in communication.
Damage in these regions can affect how a person understands language and emotional signals. For example, the person may still hear what others say, but they may have difficulty understanding tone, emotion or intention behind the words.
Key Insight
In frontotemporal dementia, the first changes often involve behaviour and personality rather than memory. This happens because the illness primarily affects the frontal and temporal areas of the brain, while memory systems located deeper in the brain may remain relatively intact during the early phase.
Why the Person May Not Notice the Changes
In many conditions, people can recognise when something is wrong. However, in frontotemporal dementia the parts of the brain responsible for self-awareness may also be affected. This means the person may not notice the changes in their own behaviour.
For families, this can feel deeply frustrating. They may feel that the person is refusing to listen or accept help. But the difficulty often lies in the brain’s ability to reflect on its own functioning.
What Helps
Clear and simple communication. Step-by-step guidance. Predictable routines. Calm environments.
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This article is part of the series:
→ Frontotemporal Dementia Care Strategies
A collection of practical guides for families living with FTD — explaining behaviour changes and what helps in everyday situations.
See all articles in the series here.