To evaluate the role of stressors in  FTD.

Currently, there is no treatment for Frontotemporal dementia (FTD).  Other than genetics, little is known about risk or protective factors in FTD.  Response to stressors may play a role in dementia. On the other hand, bilingualism may provide cognitive reserve and delay onset of dementia.  We investigated the role of these factors in FTD in a memory clinic.

Dementia  subtypes were diagnosed using a standard protocol.    Information on proficiency and languages spoken, sociodemographics, risk factors and life style factors was captured.  Stressors in the ten years prior to onset of symptoms were rated on the nature and severity   (Johansson et al 2010). ANOVA and univariate general linear model were used to study the effect of bilingualism on dementia and its interaction with dementia subtypes.

There were 832 patients (682 bilinguals,150 monolinguals).  FTD patients (n=162) were significantly younger at diagnosis [64.2 years (9.59)] as compared to patients with other dementias. Monolinguals (n=28 ) had  less education as compared to bilinguals  (n=134). There was a significant interaction between bilingualism and diagnosis after controlling for education. A  delay in onset of almost a decade was seen in bilingual patients with FTD as compared to monolinguals, but this was not seen in any of the other dementias. Stressors were quite common in patients with FTD but not significantly different from other dementias.

Bilingualism as cognitive reserve appears to be striking in FTD patients which may be due to the younger age and lower vascular risk factors.  Stressors also play a role in FTD, which require further study.  With the current focus on preventive  life style interventions in dementia, our findings have implications in delaying or slowing dementia in asymptomatic carriers and patients.