What Are the 7 Stages of Frontotemporal Dementia? Here’s What to Know
Healthy’s Summary
Frontotemporal dementia (FTD) is one of those diagnoses that can feel extra disorienting, mostly because it’s not Alzheimer’s—and yet, it can look surprisingly similar at first. The key difference? FTD hits younger (often before 65) and tends to affect personality and behavior first, not memory.
This kind of dementia develops gradually, progressing through several stages. While no two journeys look exactly alike, many caregivers and doctors use a rough “7-stage” model to understand the changes someone with FTD might go through—starting with subtle signs and ending with full-time care needs.
Whether you’re navigating a diagnosis yourself or supporting someone else, understanding these stages can help you feel a little less in the dark.
Just remember: things like genetics, overall health, support systems, and exact type of FTD (behavioral vs. language-based) can shape how this all unfolds.
Factors like age, health history, and type of FTD can affect how symptoms progress.
Let’s Talk Through the Stages—One Human Moment at a Time
1. Stage One: “Wait, something feels off.”
In the very beginning, symptoms are subtle. You (or a loved one) might just seem a bit different—more irritable, less empathetic, maybe saying odd things or repeating themselves. Friends may chalk it up to stress or aging. This stage is easy to miss.
Common signs: mild personality shifts, awkward social behavior, impulsive choices
2. Stage Two: “That’s not like them at all.”
Now, the behavior changes are a little more obvious. They may start ignoring social norms, seem unusually blunt or inappropriate, or lose interest in things they once loved.
This stage is where people start looking for answers—but often hit a maze of misdiagnoses like depression or midlife crisis.
Heads-up: This is when behavioral variant FTD (bvFTD) really shows itself.
3. Stage Three: Communication hits a snag
This one’s especially tough if the person has a variant of FTD that targets language (called primary progressive aphasia). Words start slipping away. Conversations might feel circular or confusing. The person may stop initiating chats or forget common words mid-sentence.
Ask Healthy
Tip: Try using simpler phrases, non-verbal cues, or even picture aids.
4. Stage Four: Daily life starts needing backup
At this point, things like cooking, shopping, or managing money safely get tricky. Not because of memory loss (like in Alzheimer’s), but because of poor judgment, impulse control, or planning difficulties.
You might notice they’re eating oddly, hoarding items, or dressing inappropriately for the weather. That frontal lobe damage is making decisions hard.
Real-world moment: Putting three shirts on at once, or none at all.
5. Stage Five: It’s time for full-time supervision
Even if memory still seems okay, judgment and self-care are now deeply affected. The person may wander, forget to eat, or act aggressively. They’ll need help with bathing, dressing, and staying safe.
This stage can be emotional for caregivers—don’t forget to ask for help and take breaks.
If you haven’t connected with a dementia support group yet, this is the time.
6. Stage Six: Decline accelerates
This is where movement and mobility start to get impacted. The person may walk with difficulty, need assistance standing, or have issues swallowing. Personality can feel “flattened,” and their ability to respond emotionally might fade.
You’ll also start to see serious issues with incontinence or sleep.
Practical tool: Bed alarms or chair sensors can offer peace of mind for caregivers.
7. Stage Seven: Late-stage FTD
At this final stage, speech may disappear entirely. The person is often bedridden, relying on others for everything. Swallowing becomes difficult, increasing the risk of infections like pneumonia.
It’s hard. Really hard. But you’re not alone. Hospice and palliative teams can be incredibly helpful here—for both the person with FTD and those loving them through it.
The Takeaway
Frontotemporal dementia is different from other dementias—faster, younger onset, and often more confusing in the early days. Understanding the stages can give families and caregivers a roadmap for what’s coming, even if the journey doesn’t follow it perfectly.
The most important thing? No one should go through this alone. Whether it’s support groups, care coaches, or just a friend to vent to—support matters as much as science.
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