What Is Early-Onset Alzheimer’s? (video/podcast)

Nearly everyone struggles with remembering the name of an acquaintance or forgets what they were about to say. Such occasional forgetfulness is normal, but if it begins to interfere with everyday function, it may be due to Alzheimer’s. 

Alzheimer’s is a type of dementia that affects memory, thinking and behavior. Alzheimer’s disease typically develops after age 65. However, early-onset Alzheimer’s disease can begin much earlier, typically appearing in the 40s and 50s. In families who carry a genetic mutation predicting early-onset Alzheimer’s disease, individuals may develop symptoms in their 20s or 30s, although this is not common.

In this video, San Diego Health host Susan Taylor talks with Leonard Sokol, MD, a neurologist at Scripps Clinic Torrey Pines and Scripps Clinic Encinitas, about early-onset Alzheimer’s.

While the exact cause of Alzheimer’s is unknown, researchers have found that proteins in the brain called amyloid and tau cause changes known as plaques and tangles, respectively, within brain tissues. While everyone has plaques and tangles, Alzheimer’s patients have many more, which ultimately disrupts the brain’s ability to function properly.

One of the greatest risk factors for early-onset Alzheimer’s is genetics. If your parents or grandparents had it, your risk will be higher. However, genetics account for only a small percentage of cases; environmental factors and lifestyle play larger roles.

People who develop the disease before age 65 tend to have fewer memory-related complaints.

“Oftentimes the primary symptoms that are most bothersome are non-memory in nature,” says Dr. Sokol. “Younger patients often have behavioral issues, such as irritability or aggression or have difficulties in their judgment. There can be trouble with language, navigating, processing faces or doing calculations.”

Many people experience such symptoms from time to time, so when do they become concerning? It depends on how much they affect the individual’s life. Dr. Sokol says a professional medical evaluation may be needed when symptoms become troublesome, interfere with everyday functioning, or are noticed by family members or friends.

The first step in diagnosing early Alzheimer’s is a visit with a physician, who will take a medical history, review the patient’s symptoms and perform a cognitive evaluation that may include attention span, language skills, planning and sequencing abilities, memory and other factors that make up what is known as your “executive function.” 

“We look at how well you process your visual spatial features, how you draw certain things, how you conceptualize where things are in space and make inferences,” says Dr. Sokol. “We also ask loved ones to weigh in to help us get a good sense of how others see your behavior.”

The physician also may order imaging tests, such as a CAT scan, to look for evidence of changes in the brain, as well as fluid samples from the brain and spinal cord.

“It’s often a bit of an odyssey, so it’s not something that we will know immediately,” says Dr. Sokol. “But we’ll have a reasonable, educated hunch and we work to further explore that.”

Dr. Sokol says several medications are available to help affected parts of the brain continue to communicate with each other.

In addition to medications, lifestyle can help slow the progression of Alzheimer’s and may play a role in prevention. Minimize or avoid alcohol and stay away from non-prescription medications that may affect thinking.

Dr. Sokol also recommends staying physically active, maintaining social connections and including meaningful activities that bring joy throughout the day.

“If you are experiencing cognitive changes, such as changes with your memory or attention or processing speed and other people are noticing changes, go see your primary care doctor and consider testing,” says Dr. Sokol. “We’re always more than happy to start that conversation with you.”

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