Early-onset Alzheimer’s is a form of Alzheimer’s disease that manifests in individuals in their 40s and 50s. Its symptoms include memory loss, trouble finishing routine tasks, and personality changes.
About 7 million Americans and over 55 million people worldwide are living with Alzheimer’s disease, the most common type of dementia [1, 2].
Although the condition is usually known to affect people aged 65 and over, approximately 5% of those diagnosed have early-onset Alzheimer’s disease, sometimes known as younger-onset [3]. It typically manifests in people in their 40s and 50s and sometimes even as young as 30s [4].
The majority of early-onset Alzheimer’s cases are the same. However, there are some slight differences:
Common Alzheimer’s disease. The common form of Alzheimer’s disease is present in the majority of individuals with early-onset dementia. The condition progresses similarly to how it happens in elderly persons.
Genetic (or Familial) Alzheimer’s Disease. It is quite rare. A small number of individuals possess genes directly linked to Alzheimer’s. These individuals begin to exhibit signs of the illness in their 30s, 40s, or 50s.
What Causes Early-Onset Alzheimer’s Disease?
The cause of Alzheimer’s disease is unknown. Experts hypothesize that two proteins cause nerve cell damage and death. Plaques form when fragments of the protein beta-amyloid accumulate. Tangles are the twisted strands of another protein, tau.
As people age, almost everyone gets plaques and tangles. However, people with Alzheimer’s develop much more. These plaques and tangles damage the brain’s memory regions and gradually spread to other parts.
Similar to typical Alzheimer’s, it is still unclear what specifically causes the early-onset disease. Several experts believe various factors cause this condition.
Scientists have identified rare genes that could directly trigger or contribute to early-onset familial Alzheimer’s disease [5]. The deterministic genes (the genes that directly cause the disease) include:
- Amyloid precursor protein (APP) on chromosome 21
- Presenilin-1 (PS1) on chromosome 14
- Presenilin-2 (PS2) on chromosome 1
Within a family, these genes can be passed down from generation to generation. Adults under 65 who carry these genes may experience symptoms earlier than usual.
These gene mutations constitute just 5% to 10% of all Alzheimer’s cases. However, they are risk factors for most early-onset cases [6].
Apolipoprotein E (APOE-e4) is another gene linked to Alzheimer’s. It is more prevalent in individuals who develop the disease beyond the age of 65.
Who is at Risk for Early-Onset Alzheimer’s?
Although Alzheimer’s disease is not a normal aspect of getting older, you are at a higher risk as you age.
A family history of the disorder is one of the risk factors for young-onset Alzheimer’s. Having a parent or grandparent with early-onset Alzheimer’s raises the risk of having the illness. If you have more than one family member with the condition, your chances of developing it increase. However, having a family history of the disease does not guarantee that you will also develop it.
A 2016 study found that African Americans, Native Americans, and Native Alaskans have a higher risk of experiencing early-onset Alzheimer’s disease than white people [7].
What are the Symptoms of Early-Onset Alzheimer’s?
Most patients with early-onset disease experience symptoms that are similar to those of other types of Alzheimer’s. Following are the symptoms of early-onset Alzheimer’s [4].
Early Symptoms
- Forgetting crucial things, especially recently acquired information or important dates
- Asking for the same information repeatedly
- Trouble addressing simple problems, such as keeping track of finances or following a recipe
- Losing track of the day, date, or season
- Losing track of where you are and how you arrived there
- Issues with depth perception and vision loss
- Trouble joining conversations or finding the correct term for things.
- Misplacing things and being unable to retrace your steps to find them
- Worsening judgment
- Withdrawal from workplace and social settings
- Personality and mood changes
Later Symptoms
- Personality and mood changes
- Severe mood swings and behavioral changes.
- growing confusion of location, time, and events in life
- Suspicions concerning loved ones, friends, or caretakers
- Difficulty swallowing, walking, or speaking
- Severe memory loss
How is Early-Onset Alzheimer’s Diagnosed?
Especially in early-onset Alzheimer’s, the symptoms may appear to be caused by other factors, such as stress. Individuals in middle age may avoid seeking medical assistance, dismissing their symptoms as stress-related, thereby delaying the diagnosis of the condition.
If completing daily tasks is becoming more difficult for you or a loved one, or if memory loss is getting more severe, speak with a doctor. They might suggest that you see a physician with expertise in Alzheimer’s disease.
There is no single test to diagnose Alzheimer’s. With a few tests, your healthcare professional can identify the disease.
Your doctor first inquires about your medical history. They also conduct cognitive tests to assess memory, problem-solving skills, and other mental capabilities. Your provider can also ask that you undergo additional testing with a neuropsychologist based on the findings of the office-based cognitive evaluation.
Your doctor may also examine your blood, urine, and spinal fluid. Additionally, you might require imaging tests, like brain CT and MRI scans. With the help of these, your doctor can see the extent of the damage to the brain tissue.
Other illnesses that more typically affect this age group (such as multiple sclerosis) must be ruled out before diagnosing Alzheimer’s in middle age.
Recent research has concentrated on blood tests that can detect proteins related to Alzheimer’s in the blood. Even while these seem promising, more study is required [8].
What treatment options are available for early-onset Alzheimer’s?
There is presently no cure for early-onset Alzheimer’s. However, healthcare personnel have been able to help some people maintain mental function, control behavior, and halt the progression of the disease.
Medicines can help patients retain their cognitive function. These include:
- Donepezil
- Rivastigmine
- Galantamine
- Memantine
- Lecanemab-irmb
The outcomes have been mixed. However, these medications may help patients with their symptoms for a few months to a few years.
Antioxidants, cognitive training, cardiovascular and diabetic therapies, physical activity, and other therapies may also help slow the progression of early-onset Alzheimer’s. Several studies are currently underway in this field, and researchers are discovering new things about Alzheimer’s
Since individuals in their 40s and 50s can be affected by early-onset Alzheimer’s disease, symptoms can occasionally be more disruptive to social, professional, and family life. The management of early-onset Alzheimer’s symptoms frequently focuses on providing more age-appropriate support.
Specific support may include occupational, speech, and vision therapies.
Can Early-Onset Alzheimer’s be Prevented?
While you cannot prevent early-onset Alzheimer’s, you can lower your risk. However, those who take precautions to reduce their risk of the condition may nonetheless develop the disease.
Lifestyle modifications that assist in lowering risk include:
- Getting regular exercise
- Consuming a heart-healthy diet
- Engaging in lifelong learning
- Practicing cognitive training
- Maintaining mental and social activity
- Preventing traumatic brain injuries
How can you prepare for early-onset Alzheimer’s?
Receiving an early-onset Alzheimer’s diagnosis might be upsetting. However, it allows you time to devise a strategy that will provide you with peace of mind in the future if symptoms emerge or worsen.
Managing early-onset Alzheimer’s might be challenging. Maintaining an optimistic mindset and making every effort to be physically and cognitively active are beneficial.
Understanding that you are not alone is also crucial. Don’t hesitate to rely on your loved ones and friends. Don’t be scared to join a support group if you believe it will help.
It is vital to plan for the future while the disease is still in its early stages. It can include financial planning, consulting with employers about present and possible employment obligations, verifying health insurance coverage, and preparing your vital paperwork in case your health deteriorates.
There is no known treatment for Alzheimer’s disease. However, maintaining the finest physical and mental health possible may turn an unfavorable situation around.
What is the prognosis for a person with early-onset Alzheimer’s?
Alzheimer’s disease symptoms could get worse with time. Many people experience a gap of two to four years between the onset of symptoms and their doctor’s official diagnosis. It is the first stage of the condition.
Following a diagnosis, you or a loved one may start exhibiting symptoms of the second and later stages. The duration of this mild cognitive impairment stage might range from two to ten years.
People lose their independence as their Alzheimer’s reaches its final stage. The condition is at its worst at this stage. You or a loved one may struggle to remember the names of loved ones and will undoubtedly require assistance with tasks like money management, self-care, and driving.
Alzheimer’s Research Association is a non-profit organization dedicated to helping caregivers of Alzheimer’s disease and dementia. We provide the latest information and news about the illness and helpful tips to help caregivers cope with their daily caregiving challenges. We realize the most important thing that a caregiver needs is financial assistance. Therefore, we provide grants to caregivers to ease their financial burden. Caregivers can apply for grants here: Alzheimer’s Grant Application.
You can also help caregivers in their endeavor by donating as much as possible: Donation To Alzheimer’s Research Associations.
References
- Alzheimer’s Disease Facts and Figures. Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/facts-figures. Accessed: 10th September, 2024.
- Alzheimer’s and Dementia. Alzheimer’s Association. https://www.alz.org/alzheimer_s_dementia. Accessed: 10th September. 2024.
- Mendez, M.F., 2017. Early-onset Alzheimer disease. Neurologic clinics, 35(2), pp.263-281.
- Early-Onset Alzheimer’s Disease. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/earlyonset-alzheimer-disease. Accessed: 10th September, 2024.
- Familial Alzheimer’s Disease. University of California San Francisco (UCSF). https://memory.ucsf.edu/genetics/familial-alzheimer-disease. Accessed: 10th September, 2024.
- Kumar, A., Sidhu, J., Goyal, A. and Tsao, J.W., 2018. Alzheimer disease. Last Updated: 12th February, 2024. Accessed: 10th September, 2024.
- Chen, H.Y. and Panegyres, P.K., 2016. The role of ethnicity in Alzheimer’s disease: findings from the C-PATH online data repository. Journal of Alzheimer’s Disease, 51(2), pp.515-523.
- Signs and Symptoms of Early Onset Alzheimer’s Disease. Healthline. https://www.healthline.com/health/alzheimers-disease/signs-of-early-onset-alzheimers. Updated: 22nd August, 2024. Accessed: 10th September, 2024.
- Young-onset Alzheimer’s: When symptoms begin before age 65. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048356. Accessed: 10th September, 2024.