Alzheimer's disease is the most common, irreversible form of dementia that affects memory, thinking, and behavior. It affects not only the elderly, but also people aged 30, 40 or 50. For this reason, it is called early-onset Alzheimer's disease. More about Alzheimer's disease at an early age was told for Poradnik Zdrowie neuropsychologist Dr. Anna Barczak from the Alzheimer's Department of the Ministry of Interior and Administration Hospital in Warsaw.

What is Alzheimer's at a Young Age?

First, it's worth explaining what Alzheimer's disease is. It is the most common cause of dementia in the world andis responsible for over 75% of- This disease is caused by a build-up of pathological proteins in the brain, mainly beta amyloid and tau, in the brain, gradually leading to the death of neurons. These processes cause the brain to atrophy as the disease progresses, and hence to the loss of the functions it regulates, explained the neuropsychologist Dr. Anna Barczak. She also added that " Alzheimer's disease is manifested primarily by progressive episodic memory disorders , i.e. inability to remember and recreate new information and gradually loss of independence."

Most cases of Alzheimer's disease at a young age are similar to those of the elderly. However, there may be several differences:

  1. The typical form of Alzheimer's diseaseusually occurs in young people and occurs in the same way as in seniors.
  2. Hereditary Familial Alzheimer's Disease(EnglishFamily Alzheimer's Disease)is very rare. Several hundred people are burdened with genes that directly contribute to the development of Alzheimer's disease. Symptoms of this disease appear at the age of 30, 40 or 50.

Scientists don't know what causes Alzheimer's at a young age. We turned toDr. Anna Barczak to clarify this issue.- At the beginning, two things should be distinguished: the very process of the disease, which latently damages the brain for decades, and its clinical manifestation, i.e. we call Alzheimer's dementia. It is preciselythe patient's loss of independence of functioning- she noted.

The most important risk factor for the development of Alzheimer's disease, as emphasized by the expert, is age. - The vast majority of this disease affects the elderly.In young people it is very rareand belongs to unusual presentations. The prevalence of dementia is relatively constant, but its diagnosis depends on our knowledge and the availability of specialist research. So the number of people with early-onset Alzheimer's disease as such will not increase, she added, noting that "there may be more diagnosed cases because we have better and more accurate diagnostic methods."

Can Alzheimer's disease be inherited?

This question is asked by many people. These doubts were dispelled by Dr. Anna Barczak, who stated that " most cases of Alzheimer's disease are sporadic, not hereditary , nevertheless there are rare cases (about 4-5% of all patients), in whose disease manifests itself in families ”. - Familiarity is defined as the confirmed presence of the disease in at least two people in two consecutive generations, so a sick uncle or mother-in-law does not in any way constitute familial Alzheimer's disease. The way of inheritance is autosomal dominant, which means that if we inherit a mutation from one of the parents, the disease will develop 100% - she added.

The specialist noted that "there is currently a lot of data on the pathomechanism of the disease and its modifying factors, but it is still a mystery why in some people at some point in life the deposition of pathological proteins in the brain accelerates".

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What are the symptoms of Alzheimer's at a young age?

Most young people have Alzheimer's disease at a young age similar to that of older people. - It starts with a memory impairment, an inability to remember new information, a gradual loss of everyday skills, but it occurs before the age of 65.One of my youngest patients diagnosed with Alzheimer's disease was 24 years oldand if not the family history of several sick family members, no one would suspect such a cause at this age - said Dr. Anna Barczak, MD, in an interview with Poradnik Zdrowie.

Continuing her statement, the neuropsychologist noted that "in early-onset dementia, mental disorders and neurological symptoms develop much faster than in late Alzheimer's disease."

- In case of getting sick early, also more oftenWe meet atypical variants of Alzheimer's disease, not resembling the characteristic memory problems, but occurring, for example, with isolatedlanguage or visual disorders.This was the case of the writer Terry Pratchett, who had posterior cortical atrophy, i.e. the visual form of Alzheimer's disease, in which the initial difficulties were problems with seeing, reading, writing, but with relatively preserved episodic memory (by the way, the worst possible variant of the disease for the writer) - explained the specialist.

Neuropsychologist Dr. Anna Barczak recommended that in order to diagnose Alzheimer's disease at a young age,"you cannot ignore complaints about memory impairmentjust because the patient is not elderly" . In society, she said, "dementia is rarely associated with young people, so problems are often attributed to stress, depression, schizophrenia, and accompanying somatic disease." She added that "younger patients, complaining of memory disorders, with problems in carrying out their current tasks, which are confirmed by colleagues or close ones, deserve special attention of doctors, especially if there were any cases of memory or behavior problems in the patient's family, regardless of age".

To summarize, we present what symptoms of Alzheimer's may appear at a young age.

Early symptoms:

  • forgetting important things, especially new information or important dates,
  • repeatedly asking for the same information,
  • failure to cope with basic duties, incl. problems with settling accounts or problems with memory,
  • confusion about losing awareness of a place or a time,
  • disturbed visual perception,
  • speech disorder,
  • increasingly difficult assessment of what is happening at the moment,
  • limiting contacts between people,
  • frequent change of mood.

Late symptoms:

  • serious disorientation about time, place and situation
  • irritability and frequent mood swings,
  • not trusting friends, family or caregivers
  • problems with speaking and swallowing food or fluids,
  • gait disturbance,
  • memory loss.

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What are the phases of Alzheimer's at a young age?

Specialist Dr. Anna Barczak explained how Alzheimer's disease develops insidiously and proceeds in the following stages:

  1. Early Alzheimer's Disease ,where the deposition of pathological proteins begins, is "completely mute clinically, and neither the patient nor his surroundings notice any symptoms."
  2. Mild cognitive impairment phase- memory deficits are experienced by the patient and noticeable in a medical examination.
  3. The clinical phase of the so-called stage of dementia- also dementia, which is not a disease in itself, can be divided into several stages. Alzheimer's disease is commonly associated with a state of complete loss of contact with the world, disturbed behavior and bedridden.
  4. Moderate dementia- preceded by significant problems in terms of independence, being lost in the environment, speech disorders, irritability, possible aggression, agitation, delusions, hallucinations. In the initial or mild stages of dementia, which almost overlaps with mild cognitive impairment, often only memory symptoms are observed, and problems with daily functioning only concern the more complex activities.

Dr. Anna Barczak emphasized that "from the point of view of the effectiveness of treatment, the most important thing is to identify dementia and the underlying disease at the earliest stages of dementia."

How is Alzheimer's disease diagnosed at a young age?

The current diagnosis of Alzheimer's disease at a young age is based on the recognition of whether there has been a deterioration in mental performance. As Dr. Anna Barczak explained, "the diagnosis of Alzheimer's disease is based on the published diagnostic criteria and available guidelines, thereforethe most important thing is to know the clinical picture of the disease and the criteria for diagnosing ".

- In practice, this requires collecting an interview from the patient and his family, which allows to determine how long the problems have existed, what they concern and whether they significantly interfere with the patient's daily functioning. And it's not about the independence of eating, walking and remembering your name, but most of allloss of ability to perform complex taskswith which the patient has not had any problems with early diagnosis - she added.

The neuropsychologist said the next step in diagnosing Alzheimer's at an early age was to "objectify the problems using one of several screening tools available."Additional research is necessary in order to exclude other causes of the cognitive deterioration of the patient . A specialist doctor is required to conduct them - a neurologist, psychiatrist, geriatrician.

- One of the most important studies is neuroimaging (computed tomography or magnetic resonance imaging),which usually allows to exclude other diseases of the central nervous system. If, after this procedure, there are still diagnostic doubts, then highly specialized diagnostics is necessary, such as neuropsychological examination, functional examination of the brain, assessment of biomarkers from the cerebral - spinal fluid and, in justified cases, genetic tests - said Anna Barczak, MD.

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How is Alzheimer's disease treated at a young age?

Treatment of Alzheimer's disease at a young age can begin after establishing the presence of dementia. A specialist doctor then usually startsdedicated pharmacological treatmentafter taking into account contraindications.

- Current pharmacotherapy is able to alleviate the symptoms of dementia, not improve memory, so it is started only when the patient has symptoms of dementia. Even if it is known from other studies that the patient suffers from Alzheimer's disease,drugs are started only after the development of clinical symptoms of dementia- explained Dr. Anna Barczak.

As the neuropsychologist pointed out, "in the pre-dementia phasesnon-pharmacological interventions are recommended- cognitive training, changing the lifestyle to a he althier one, prophylaxis of somatic diseases to postpone the development of dementia as much as possible ". - The same also applies to the newest drug intended for people with Alzheimer's disease, which is still in the final phase of clinical trials in Europe, i.e. aducanumab. I specifically use the term Alzheimer's disease, not dementia, because this drug is effective only in people with mildly severe symptoms, and in patients who have been ill for many years, it will not be effective - she clarified

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Neurology