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Alzheimer's can come early
Research continues into the who, what, why and when of Alzheimers disease. But why does this memory-robbing disease strike younger adults?
Its called early-onset Alzheimers. Dr. Lisa Silbert, Associate Professor in the Oregon Health & Science University Department of Neurology, says, Early-onset Alzheimers disease is considered when Alzheimers is diagnosed before the age of 65. Most cases of Alzheimers disease occur in individuals who are 65 or older. Silberts colleagues have seen Alzheimers in patients as young as their late 30s.
Silbert, who is also director of the Neuroimaging Lab at the Oregon Alzheimers Disease Center, pointed out about 5 percent of Alzheimers cases are considered early onset.
Whether youre an older or younger adult, Alzheimers 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 Alzheimers, Silbert says some patients present with a gene mutation thats passed on from their families.
We know of three specific genes that we can test for that confer early-onset Alzheimers disease, she said. Theyre pretty rare, and we dont recommend testing in all early-onset cases, only early-onset cases in which theres a very strong family history of the disease.
Early signs of the disease are similar in all Alzheimers 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 youre not missing some other cause, something thats 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 Alzheimers is that the disease can be hard to diagnose. People really arent expecting that in a younger age group, Silbert said. Often it can be missed initially and its really not until the symptoms show themselves to be clearly progressive that theres 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 Alzheimers 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 Alzheimers patients.
The literature is mixed in terms of disease duration in early-onset Alzheimers, she said. In older-onset Alzheimers 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.
Whats frustrating about Alzheimers disease is that theres no known cure. In young-onset, we really do a very thorough workup to exclude other causes, Silbert said. We want to make sure were 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 Alzheimers. There are four FDA-approved medications to treat Alzheimers 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 theyre 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 Alzheimers 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 thats going to translate into better treatment options in the near future. Were 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 Alzheimers. Many people who develop late-onset Alzheimers 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: