Early-onset Alzheimer’s disease is a rare form of dementia that occurs between the ages of 30 and the mid-60s, and usually affects many members of a single family. It represents less than 10 percent of all cases of Alzheimer’s. An estimated 200,000 Americans have early-onset Alzheimer’s.

Types

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

Common Alzheimer’s disease

Most people with early-onset Alzheimer’s have the common form that progresses the same way it does in older people (65 years and older) with the disease.

Genetic Alzheimer’s disease

In this extremely rare form, affecting about 1 percent of Alzheimer’s patients, an inherited alteration in a specific gene directly contributes to the disease. This is also known as early-onset familial Alzheimer’s disease (eFAD). Patients are likely to have a parent or grandparent who also got the disease at an early age. A child who has a parent with a genetic mutation for eFAD has a 50 percent chance of inheriting that mutation and developing eFAD themselves.

So far three such genes have been identified — APP, PSEN1 and PSEN2. They are located on chromosomes 21, 14 and 1. Mutations in these genes cause formation of abnormal proteins. For example, a gene mutation on chromosome 21 causes the formation of abnormal amyloid precursor protein (APP), a mutation on chromosome 14 causes abnormal presenilin 1 to be made, and a mutation on chromosome 1 leads to abnormal presenilin 2 formation. These abnormal proteins play a role in the breakdown of APP, which generates harmful forms of amyloid plaques, a hallmark of the disease. Consider genetic testing for these mutations only after professional counseling.

Cases of eFAD that do not involve mutations in these three genes exist, suggesting the involvement of additional genes. 

Symptoms

Symptoms of early-onset Alzheimer’s include:

  • Memory problems that interfere with everyday life. These may include forgetting important things, messages or recent events which would normally be remembered.
  • Repeating questions and asking for the same information again and again.
  • Difficulty keeping track of bills or following a favorite recipe.
  • Losing track of the date or time of year.
  • Losing track of where one is and how he or she got there, or misplacing things and not being able to retrace steps to find it.
  • Increasingly poor judgment.
  • Deepening confusion and disorientation about time, places and life events. People may become confused in unfamiliar situations.
  • Changes in personality and behavior, which may be subtle at first and may include apathy, depression or loss of confidence.
  • Severe mood swings and behavioral changes.
  • Difficulty speaking, swallowing or walking.
  • Withdrawal from work and social situations. Difficulty joining conversations or finding the right word for something (also known as aphasia).
  • Being suspicions about friends, family or caregivers.
  • Visual problems including difficulty recognizing words and objects, difficulty with depth perception and judging speed or distance. When visual problems are a major symptom, the disease may be called posterior cortical atrophy.

Diagnosis

Diagnosing early-onset Alzheimer’s relies on detecting the symptoms and signs of mental decline. It requires a few tests including a medical history examination  and cognitive tests of memory, problem-solving and other mental skills. A physician might also test blood, urine and spinal fluid. Computerized tomography (CT) and magnetic resonance imaging (MRI) brain scans can be used to reveal the extent of damage.

Management

No cure currently exists for early-onset Alzheimer’s. However, patients may get assistance for maintaining mental function, controlling behavior and slowing the disease’s progression.

Drugs used to maintain mental function include Aricept (donepezil), Exelon (rivastigmine), Reminyl (galantamine) and Namenda (memantine). Depression and seizures can also be treated with appropriate medications.

Physical therapy, occupational therapy, cognitive training, antioxidants, and cardiovascular and diabetes treatments may also slow the progress of early-onset Alzheimer’s. Patients should also maintain a healthy diet, get regular exercise, cut down on alcohol and use relaxation techniques to reduce stress.

Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.