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PAMPLIN MEDIA GROUP: SCOTT KEITH - Dr. Lynne Shinto and colleague Dr. Lisa Silbert of Oregon Alzheimers Disease Center. Research continues into the who, what, why and when of Alzheimer’s disease. But why does this memory-robbing disease strike younger adults?


It’s called early-onset Alzheimer’s. Dr. Lisa Silbert, Associate Professor in the Oregon Health & Science University Department of Neurology, says, “Early-onset Alzheimer’s disease is considered when Alzheimer’s is diagnosed before the age of 65. Most cases of Alzheimer’s disease occur in individuals who are 65 or older.” Silbert’s colleagues have seen Alzheimer’s in patients as young as their late 30s.

Silbert, who is also director of the Neuroimaging Lab at the Oregon Alzheimer’s Disease Center, pointed out about 5 percent of Alzheimer’s cases are considered early onset.

Whether you’re an older or younger adult, Alzheimer’s disease is a neurodegenerative disorder that causes progressive dementia, she said, noting the disease results from an accumulation of abnormal protein in the brain.

“What happens throughout the course of the disease is that there is a progressive decline in cognitive function, which leads to difficulties in everyday function,” according to Silbert.

In determining risk factors for early-onset Alzheimer’s, Silbert says some patients present with a gene mutation that’s passed on from their families.

“We know of three specific genes that we can test for that confer early-onset Alzheimer’s disease,” she said. “They’re pretty rare, and we don’t recommend testing in all early-onset cases, only early-onset cases in which there’s a very strong family history of the disease.”

Early signs of the disease are similar in all Alzheimer’s age groups. Among these signs: short-term memory loss.

“If someone is having changes in their short-term memory, this is something they first would need to bring up with their primary care provider, mainly because, particularly in younger onset cases, you really need to make sure you’re not missing some other cause, something that’s more reversible or treatable,” Silbert said, noting metabolic abnormalities, such as thyroid disease or Vitamin B12 deficiencies, can cause similar symptoms.

A problem with early-onset Alzheimer’s is that the disease can be hard to diagnose. “People really aren’t expecting that in a younger age group,” Silbert said. “Often it can be missed initially and it’s really not until the symptoms show themselves to be clearly progressive that there’s more concern and more of a workup involved.”

As the disease progresses, a patient can find it hard to multitask or follow multi-step instructions. That can lead to difficulty performing day-to-day tasks such as managing finances or managing medications. A younger-onset Alzheimer’s patient, she said, may also have other problems, besides dementia, such as seizures and jerking of the muscles.

In can be tricky determining life expectancy in early-onset Alzheimer’s patients.

“The literature is mixed in terms of disease duration in early-onset Alzheimer’s,” she said. “In older-onset Alzheimer’s disease, the average life expectancy from diagnosis to death is about 10 years.” Silbert notes some studies indicate that early-onset disease can progress a bit quicker.

What’s frustrating about Alzheimer’s disease is that there’s no known cure. “In young-onset, we really do a very thorough workup to exclude other causes,” Silbert said. “We want to make sure we’re not missing some other central nervous system infection, or autoimmune disease, or metabolic deficiency.”

Treatment is the same for older and younger individuals suffering from Alzheimer’s. “There are four FDA-approved medications to treat Alzheimer’s disease, three of them working on the same mechanism,” she said, noting that replacing a neurotransmitter with medication, you can delay the onset of functional decline.

Glancing ahead at the future, Silbert is optimistic. “We now have better imaging tools to diagnose the disease, which are not quite ready for clinical practice yet because they’re very expensive and not yet covered by insurance,” she said, noting that these new imaging modalities include PET imaging, which, she added, can help discover abnormal proteins in the brain.

Silbert is happy that new technologies are evolving to help Alzheimer’s patients. “There are so many new and exciting technologies that have come out since I started doing this that have really helped in diagnosis,” she said. “I expect that’s going to translate into better treatment options in the near future. We’re on the right course in terms of actually getting a handle on this disease.”

COPING SUGGESTIONS FOR COUPLES

The loss of intimacy is something poignant with early-onset Alzheimer’s. Many people who develop late-onset Alzheimer’s have already been widowed. But couples in their 40s or 50s are often in the middle of their lives together.

Spouses or partners face the possibility of spending many years without an active partner. Losing the romantic component and changing to a caregiver status complicates the relationship. Try to:

  • Communicate about changes you’re experiencing and ways in which your needs also may have changed. Don’t be afraid to ask for help.
  • Find new activities that you can enjoy together.
  • Keep a folder of resources you may need as the disease progresses.
  • - mayclinic.org


    Scott Keith is a freelance writer with the Portland Tribune and the Pamplin Media Group. If you have a health tip, or a story idea, contact Scott at This email address is being protected from spambots. You need JavaScript enabled to view it..

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