When Personality Begins to Change
Early signs of personality change in frontotemporal dementia and how to understand them
For many families, the first signs of frontotemporal dementia do not look like memory problems. Instead, something else changes. It may be the way the person speaks to others. It may be a loss of empathy. It may be impulsive behaviour that feels completely out of character.
What Is Frontotemporal Dementia?
Frontotemporal dementia (FTD) is a condition that affects the frontal and temporal parts of the brain. These areas are responsible for many functions that shape who we are as people. They help us understand social situations, regulate impulses, show empathy, plan and initiate actions, and adapt our behaviour to different environments.
When these parts of the brain are affected, the changes may appear primarily in behaviour and personality rather than in memory. This is why families often describe the early phase of the illness as “losing the person we knew.”
Why Behaviour Changes
The frontal parts of the brain function as a kind of internal regulation system. They help us pause before acting. They allow us to interpret other people’s reactions. They help us adjust our behaviour to the situation we are in.
When these functions are affected, several changes may occur: the person may act impulsively, social boundaries may disappear, empathy may be reduced, and judgement may become impaired. These changes are not intentional. They are the result of changes in the brain.
Key Insight
Because the person may still look physically healthy and may speak normally, others may believe the behaviour is deliberate. This misunderstanding often creates conflict within families.
Why Families Often Experience Shock
Frontotemporal dementia often appears earlier in life than many other forms of dementia. Many people develop symptoms in their 40s, 50s or early 60s. At this stage of life, families may still be working, raising children or planning the future together.
When behaviour suddenly changes during this phase of life, the impact can be profound. Partners may feel that the relationship has changed overnight. Children may feel confused or embarrassed by the behaviour of a parent. Friends may withdraw because they do not understand what is happening.
Why the Person Often Lacks Insight
One of the most difficult aspects of frontotemporal dementia is that the person with the illness often does not recognise the changes themselves. This is not denial. It is part of the disease. The brain systems that normally allow us to reflect on our own behaviour may also be affected.
Practical Advice
Stay calm when behaviour changes. Avoid long explanations. Focus on the situation here and now. Reduce situations that trigger stress.
Reflection for Families
You may find it helpful to reflect on the following questions:
• What changes did you notice first?
• Which situations are most difficult right now?
• When does communication work best in your home?
• Are there situations that could be simplified or avoided?
Small adjustments in everyday situations can often reduce stress for both the person with the illness and the family.
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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.