What is Early-Onset Alzheimer’s Disease?


December 7, 2022

What is Early-Onset Alzheimer's Disease?

What is early-onset Alzheimer disease?

Alzheimer disease is the most common form of dementia. It affects your memory, thinking, and behavior. It often progresses to the point where it affects daily activities and functions.

Alzheimer disease most commonly affects older adults, but it can also affect people in their 30s or 40s. When Alzheimer disease occurs in someone under age 65, it is known as early-onset (or younger-onset) Alzheimer disease.

A very small number of people with Alzheimer disease have the early-onset form. Many of them are in their 40s and 50s when the disease takes hold.

Most types of early-onset Alzheimer disease are the same, but there are a few small distinctions:

  • Common Alzheimer disease. Most people with early-onset Alzheimer disease have the common form of the disease. The disease progresses in roughly the same way as it does in older people.
  • Genetic (familial) Alzheimer disease. This form is very rare. A few hundred people have genes that directly contribute to Alzheimer disease. These people start showing symptoms of the disease in their 30s, 40s, or 50s. 

What causes early-onset Alzheimer disease?

Experts don’t know what triggers the start of Alzheimer disease. They suspect 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 Alzheimer disease develop many, many more. At first, these plaques and tangles damage the memory areas of the brain. Over time, they affect more areas of the brain. Experts don’t know why some people develop so many plaques and tangles, or how they spread and damage the brain.

What are the risks for early-onset Alzheimer disease?

Family history of the disease is the only known risk factor at this time.

What are the symptoms of early-onset Alzheimer disease?

For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.

Early symptoms:

  • Forgetting important things, particularly newly learned 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
  • Losing track of where you are and how you got there
  • Trouble with depth perception or other vision problems
  • Trouble joining conversations or finding the right word for something
  • Misplacing things and not being able to retrace your steps to find it
  • Increasingly poor judgment
  • Withdrawal from work and social situations
  • Changes in mood and personality

Later symptoms:

  • 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 is early-onset Alzheimer disease diagnosed?

The current diagnosis of early-onset Alzheimer disease relies on detecting the signs of mental decline noted above. Your healthcare provider can then diagnose Alzheimer disease with a few tests.

First, your healthcare provider asks about your health history, and also does cognitive tests of memory, problem solving, and other mental skills. Depending on the results of the office-based cognitive testing, your provider may also request that you have more detailed testing done with a neuropsychologist. Your provider might also test your blood, urine, and spinal fluid. You may also need certain imaging test such as CT and MRI scans of your brain. These give your provider a closer look at brain tissue to show how much damage there is.

In the future, researchers hope that studies on biomarkers will allow experts to diagnose the disease more quickly. Biomarkers are proteins in the body, or other types of markers that reliably indicate the progress of a disease.

How is early-onset Alzheimer disease treated?

Early-onset Alzheimer disease currently has no cure. But healthcare providers have been successful in helping people maintain their mental function, control behavior, and slow the progress of the disease.

Medicines are used to help people maintain mental function. They include:

  • Donepezil
  • Rivastigmine
  • Galantamine
  • Memantine

Results have been mixed, but these medicines seem to help people with their symptoms for anywhere from a few months to a few years.

Other treatments that may play a role in slowing the progress of early-onset Alzheimer disease include physical activity, cardiovascular and diabetes treatments, antioxidants, and cognitive training. A number of studies are ongoing in this area, and researchers are learning new things about Alzheimer disease every day.

Can early-onset Alzheimer disease be prevented?

Experts don’t know how to prevent Alzheimer disease. Recently, some evidence showed that detecting the disease early can lead to better treatment options. It’s best to look for any of the early warning signs mentioned above and see your healthcare provider immediately, if you notice any.

Living with early-onset Alzheimer disease

Early-onset Alzheimer disease can be a difficult disease to cope with. It helps to have a positive outlook and to stay as active and mentally engaged as possible.

It’s also important to realize that you are not alone. Rely on your friends and family as much as possible. Don’t be afraid to seek out a support group if you feel it might be helpful.

When the disease is still in its early stages, it’s critical to think about the future. This can include financial planning, working with employers on current and potential job responsibilities, clarifying health insurance coverage, and getting all your important documents in order should your health take a turn for the worse. 

Although Alzheimer disease has no cure, you can make the best of a bad situation by keeping your mind and your body as healthy as possible. This can include eating a healthy diet, getting regular exercise, cutting down on alcohol, and using relaxation techniques to reduce stress.

Source: Johns Hopkins Medicine

We hope this information is helpful to you in the important work you do as a family caregiver.
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