Early onset Alzheimer’s disease – what you should know

Early onset Alzheimer’s disease – what you should know

Think Alzheimer’s disease is only a disease of the elderly?  Think again. We assume developing any form of dementia, such as Alzheimer’s disease (AD), will happen when we are old with few years left.  Unfortunately, this is not always the case.  There is a form of AD called early onset AD which can strike people younger than age 65.  This uncommon form of dementia includes only about 5 percent of all people with AD with most victims developing symptoms of the disease in their 40s and 50s.

What is early onset AD?

Out of all forms of dementia, AD is the most common form.  It generally occurs in people 65 and older but an uncommon form called early onset AD, is one developing years before AD usually strikes. 

It is not known what triggers the start of AD and with early onset AD, researchers and doctors do not know the exact cause of why this condition appears in some people at an early age.  What is known is in a few hundred families worldwide, scientists have pinpointed several rare genes that directly cause AD.  Members of families who inherit these rare genes tend to develop symptoms as early in their 30s, 40s, and 50s.  When AD is caused by deterministic genes, it is called “familial Alzheimer’s disease,” and many family members in multiple generations are affected. 

The only known risk factor for early onset AD is a family history of the disease. 

However, most people with early onset AD have the common form of the disease.  The disease progresses in roughly the same way as it does in older people.

What causes early onset AD?

Again, the cause of early onset AD is not completely understood.  It is suspected that 2 proteins damage and kill nerve cells.  Fragments of one protein, beta-amyloid, build up and are called plaques.  Twisted fibers of another protein, tau, are called tangles.  Almost everyone develops plaques and tangles as they age.  But those with AD develop a lot more.  At first, these plaques and tangles damage the memory areas of the brain.  Over time, they affect more areas of the brain.  It is not known why some people develop so many plaques and tangles, or how they spread and damage the brain. 

What are the symptoms of early onset AD?

The symptoms of early onset AD tend to mirror the same symptoms as those of other forms of AD:

·      Forgetting important things, particularly newly leaned information or important dates

·      Asking for the same information again and again

·      Trouble solving basic problems, such as keeping track of bills or following a favorite recipe

·      Losing track of the date or time of year

·      Trouble with depth perception or other vision problems

·      Trouble joining conversations or finding the right work for something

·      Misplacing things and not being able to retrace your steps to find it

·      Increasingly poor judgement

·      Withdrawal from work and social situations

·      Changes in mood and personality

The later stages of early onset AD can include:

·      Severe mood swings and behavior changes

·      Deepening confusion about time, place, and life events

·      Suspicions about friends, family, or caregivers

·      Trouble speaking, swallowing, or walking

·      Severe memory loss

How early onset AD is diagnosed

Early onset AD is diagnosed primarily through observations and detecting the signs of mental decline.  Usually it is a close family member or spouse who is noticing changes in their loved one who takes them to their family physician to be evaluated.  Physicians will ask about the person’s health history, and will also do cognitive tests of memory, problem solving, and other mental skills.  Depending how well the person performs on evaluation tests, the physician may want to test their blood, urine, and spinal fluid.  Imaging tests such as CT and MRI scans may also be required or requested.  Imaging tests allow doctors to get a closer look at the brain to observe how much damage has occurred.

It is hoped in the future, that studies on biomarkers will allow doctors to diagnose the disease more quickly.  Biomarkers are proteins in the body, or other types of markers, that can provide reliable indication and progress of the disease.

What is the treatment for early onset AD?

Being given a diagnosis of early onset AD can be difficult to cope with.  When a person is diagnosed early and treatment begun right away, this can lead to a better quality of life.  At the first signs of possible early onset AD, it is important to get an accurate diagnosis to begin treatment.  Currently there is no way to know how to prevent AD.  But, there are some medications that have been helpful in slowing down the progress of this disease in addition to helping maintain mental functioning and controlling behavior. 

Even though early onset AD and the more common form of AD have no cure, what helps is to keep the mind and body as healthy as possible.  This can include eating a healthy diet, getting in regular exercise, cutting down on alcohol, and using relaxation techniques to reduce stress.

Joining support groups for AD and relying on family and friends can also be of significant help.  This reassures the person with AD to realize they are not alone when facing this diagnosis.