Imagine that you tell your 55-year-old mother that you are getting married and that she is too disorganized to help you with the preparations for the wedding. Or he puts his children on the bus to elementary school and the 57-year-old driver forgets the route.
These are real scenarios, extracted from my clinical work with patients who have early onset Alzheimer's.
This is the other side of dementia, with no white hair or wrinkles. And it's relatively common. Approximately five percent of Alzheimer's patients are younger than 65.
While the underlying pathology of early-onset and late-onset Alzheimer's disease is the same (the abnormal accumulation of proteins called amyloidosis and tau in the brain), there are significant differences in how the two diseases are experienced.
Patients who are under 65, for example, often have difficulties with language, visual processing and organization and planning. They have less than the classic complaints of memory.
There is also evidence that early-onset Alzheimer's progresses faster.
Carmela Tartaglia is a clinical scientist at University Health Network and an associate professor at the University of Toronto. She cautions that many young patients lack key symptoms
Dementia confused with depression
The path to a diagnosis of Alzheimer's or other dementia is often long, meandering and riddled with misdiagnoses.
A correct diagnosis is essential for each patient, but especially important for younger people. They often still work and risk losing their jobs. They can have small children. When they tell people that something is not right, they are told they are depressed or going through a middle-aged crisis.
Many times, younger patients will notice changes in their cognition at very early stages. They may notice greater difficulty in organizing or planning. They can forget about how to do complex tasks or forget about appointments. Cognitive impairment is most obvious when performing highly demanding tasks at work or when coordinating family logistics.
When a young person goes to see their doctor and reports such changes in cognition, the word & # 39; d & # 39; d & # 39; What is mentioned is usually depression and not dementia.
Until the correct diagnosis is made, there can be many misinterpretations of your thinking changes, which results in conflicts with family, friends and colleagues.
Divorce before diagnosis
Initially, a change in personality can be misinterpreted by the partner as indifference, as a mid-life crisis or as something else.
There may be a change of roles within a couple and it is not uncommon for a separation or divorce to occur before a diagnosis is made.
In the case of young children, it can be difficult for them to understand the change in their parents' personality.
Getting services for early-onset Alzheiner can be especially challenging. There are very few programs that serve people with dementia under 65 years of age.
There is also a lack of support for caregivers and relatives of these patients. There is a great need for specialized programs and long-term care facilities that can accommodate children under 65 years of age.
Use it or lose it & # 39;
Although we have no cure for any Alzheimer's patient, there are clinical trials that target the abnormal proteins that accumulate during the disease.
There are symptomatic medications, such as acetylcholinesterase inhibitors, that can help memory.
We also promote a healthy lifestyle that includes aerobic exercise because the evidence shows that this can delay neurodegeneration. We want people to remain cognitively active and continue to learn to help their brain reserve.
Although patients with early onset Alzheimer's are harmed in some activities, there are many other activities in which they can participate. "Use it or lose it" is the motto with which we must live when it comes to the brain and preserve its function.
Early-onset Alzheimer's is not the only dementia that typically affects young people. Frontotemporal dementia also affects young people. And although there are differences in the presentation of these two diseases, many of the challenges that patients face are the same.
Continuous research is required to better understand this disease. While we seek a cure, we must appreciate the special needs of this population. We need to focus on research and services to better serve patients and their families.