I’ve noticed a change in my grandfather’s behavior over the past two or three years, and it seems like the changes are intensifying and forming a pattern. I am concerned that he may have either behavioral-variant frontotemporal dementia (bvFTD or just FTD) or vascular dementia (VD). Let’s start with the risk factors. He has hypertension, diabetes, high cholesterol, is obese, and refuses to go to the doctor (which is itself evidence of a problem with executive functioning). His own father died from what was said to be Alzheimer's, but I understand that back then (late 80's) FTD and VD were frequently misdiagnosed as AD and that both VD and especially FTD are highly hereditary.
Now the behavior changes. He has turned into Dr. Jekyll and Mr. Hyde. Most days, he is is usual self. He is usually happy to be around my wife and our baby daughter. But there are days when he is a completely different person. When he is in “Hyde” mode, he is verbally abusive to me and to my wife. Even on his good days, he is socially withdrawn and does not want to be around friends or family, especially the in-laws.
Other symptoms have included:
* Less attention to physical appearance; when he eats he tends to stain his shirt and cuffs with sauce or grease, and does not care.
* Near-misses when driving, including with a police officer who was directing traffic.
* “Tuning out” during conversation, being unresponsive, or abruptly changing the topic.
* Some questionable investment decisions, including unwisely pulling money out of the market and lending money to friends who are broke and unlikely to ever repay
* Inappropriate facial expressions such as annoyance in front of his child cousins-in-law for no reason.
* Some motor issues, such as dropping items that are handed to him, and lethargic movement in general; he used to walk and take the stairs but now refuses to exercise.
* Some difficulty finding words; one time he took four seconds to remember the baby’s name, and about the same time to remember the word “baby” (i.e., “how is the… the… the… baby doing?”)
* Some trouble with short-term memory, on one occasion he forgot the name of a movie that he just saw, another time he forgot to bring an important document to work from the week prior, and on another he forgot the address of his in-laws. He frequently forgets the location of his phone and his computer passwords. But he seems able to function fine at a very intense office job, which leads me to think that it is not Alzheimer’s, as FTD and VD both feature losses in other areas as the first symptom.
I am journaling his symptoms secretly in the hope of eventually being able to make an intervention and convince him to go to the doctor and get checked out. I would appreciate any feedback or experiences from anyone who has been in a similar situation with a loved one who has had similar symptoms and refuses care. Thank you very much for your help.