Named after Arnold Pick, who first identified this syndrome, Pick’s disease is a rare form of frontotemporal dementia, found predominantly in people between 40 and 60 years old, but sometimes striking patients as young as 20. The disease causes the frontal and temporal lobes of the brain to shrink. This is brought about by the formation of an abnormal type or amount of the tau protein in the nerve cells of these areas. These abnormal cells are referred to as Pick cells or Pick bodies. While scientists have not yet ascertained the exact cause of this abnormality, there is a strong possibility that it may be genetic.
The National Institute of Neurological Disorders and Stroke defines Pick’s disease as a progressive and irreversible condition. Symptoms include personality and language changes, as well as physical symptoms, such as muscle stiffness, general weakness, loss of coordination, urinary incontinence, and memory loss. The most alarming and severe changes are in the behavioral area, and most commonly include mood swings, inappropriate behavior in social situations, repetitive or compulsive behavior, and deterioration of personal hygiene. Language changes include a decrease in the ability to read and write, difficulty speaking and understanding speech, and loss of vocabulary.
According to PubMed Health, medications and therapy are used with varying results to slow or ease the symptoms of the disease, but the outcome invariably is total disability and eventual death. Life expectancy of the Pick’s disease patient ranges from 2 to 10 years depending on the progression of the disease. Death may be brought on by infection or general shutdown of the body systems.
Drugs may be necessary to improve behavior that endangers the patient or those around him. Antidepressants can be used to ease mood swings. Treatments and aids to improve hearing and eyesight can be helpful in delaying speech and language recognition problems. Reality orientation and behavior modification can be used to reduce disorientation and inappropriate behavior. It is also important for the Pick’s disease patient to avoid situations that cause confusion or disorientation.
As the disease progresses, the patient will require constant monitoring. The patient's ability to care for him- or herself will decrease, necessitating professional care, such as a housekeeper, nurse's aide, or visiting nurse. Institutionalization may be required in the end stages of the disease.
Medline Plus suggests that patients in the early stages of Pick’s disease may want to seek out legal assistance to obtain a power of attorney for a trusted friend or relative to handle their affairs when they become unable to do so. Other documents, such as a Living Will, could also be helpful in ensuring that medical treatment is in compliance with the patient's wishes.
Research into this disease is ongoing. Although the prognosis is grim at this time, there is no reason to believe that a cure, or at least an effective treatment, cannot be found in the future.