Alzheimer’s disease in young people: causes, symptoms and treatment

A disease associated with old age, but which can also affect young adults.

Alzheimer's disease, a neurodegenerative disorder that is devastating for the life of the sufferer and those around him, very often manifests itself in old age. However, this is not always the case. Although it is not as frequent, it can appear before the age of 65 and even in early adulthood.. In fact, the first presentation of the disease is described in the case of a 55-year-old woman.

There is some reason to believe that Alzheimer's disease that presents in old age and that which manifests during adulthood, although sharing many characteristics, may actually be variants of the same clinical entity. How does this disease appear and how can we detect it early, then?

Characteristics of Alzheimer's disease

The aim of this article is not to provide an exhaustive definition of the classic presentation of Alzheimer's disease, but it is necessary to refresh your memory and remind you of the most characteristic symptoms of Alzheimer's disease.

Alzheimer's disease in old age

The most common clinical presentation is episodic memory loss, which is accompanied by a progressive deterioration in other cognitive domains such as voluntary movements or the ability to produce and understand language. This definition is not rigid, since many other cases present a focal impairment of only one of the domains without memory impairment. Therefore, when we speak of Alzheimer's disease we are talking about a very heterogeneous set of presentations that all have the same cause.

At the cerebral level, we observe the formation of senile plaques and neurofibrillary tangles. Plaques are nothing more than deposits of peptides that form with aging. It is common to have these plaques even in healthy adults, but we find a greater number of them in patients with Alzheimer's disease. Neurofibrillary tangles, on the other hand, are hyperphosphorylated conglomerates of tau protein. Their presence in the brain is also predictive of neurocognitive disorder.

Alzheimer's disease in young adulthood

About 4% of Alzheimer's patients are diagnosed before the age of 65.. The most frequent form of onset of Alzheimer's disease in young adulthood is not through memory loss, but through non-amnestic syndromes. For example, visuospatial dysfunctions, apraxias, anomias, and so on. Thus, we will find that executive, visuospatial and motor functions are often affected in these patients, confusing the diagnosis with other disorders.

At the brain level, like their older analogs, these patients also have an increased number of senile plaques and neurofibrillary tangles.. However, their location is different. In young adults who develop Alzheimer's disease, the hippocampus is preserved and free of involvement by these deposits. Let us remember that the hippocampus is a cardinal point in the acquisition and retrieval of memory. This finding explains to a large extent the difference in the presentations, why in the elderly the memory is affected from the very beginning and why in young people with Alzheimer's this is infrequent.

Neuropathology shows that there is a higher density and more diffuse distribution of typical Alzheimer's signs. Structural neuroimaging studies show that the cortex is more affected than in elderly patients and also more diffusely, especially affecting the neocortex.

Taking all this evidence into account, it is possible to state that although both manifestations fall under the label of Alzheimer's disease because they meet the same diagnostic criteria, the pathological processes suffered by young people are different from those found in older patients. The lesions are distributed differently, so we could be talking about two variants of the same disease, not just a criterion of temporality.

Causes of Alzheimer's disease in young people

In Alzheimer's disease occurring in old age, the disease is caused by the formation of natural deposits. The older the patient is, the more likely it is that he or she will have so many waste deposits that his or her cognitive abilities begin to deteriorate. Also, one's lifestyle may or may not protect the formation of such deposits present in the disease.

However, in normal young patients, there is no time for these deposits to form.. No normal process justifies such density and pathological distribution in the brain. This is why many of the early-onset Alzheimer's cases occur because of mutations in the genes that allow protein deposits to accumulate and senile plaques to form.

Instances of Alzheimer's due to genetically transmitted mutations are rare. Most cases are thought to occur by acquisition, or because the genes involved are not doing their job optimally. It seems more the product of an accumulation of genetic factors and lifestyles that produce oxidative stress than a specific gene or marker. Naturally, those who come from families with a marked history of Alzheimer's disease at a young age can, if they wish, undergo a test where a marker can be found for the presence or absence of this genetic mutation and know whether or not they will develop the disease.

Treatment and prognosis

The treatment of Alzheimer's disease in young people is the same as that prescribed for older people, with the advantage that they are able to perform more therapeutic activities than the latter. It is very important to maintain activities of daily living as long as possible and not to stop doing them because they have been diagnosed. Autonomy and activities allow the individual to retain cognitive abilities for much longer and the decline is more gradual.

Cognitive stimulation through activities that utilize brain functions is a good protector against disease progression. It is impossible to get rid of it or stop it, so the goal is to retain as much autonomy and quality of life as possible for as long a period of time as possible. It may be a good idea to make plans on how to manage life later on when one starts to become more dependent on others and is unable to manage issues such as one's finances, legal formalities, one's will or one's will towards certain medical procedures that one might be subjected to later on.

The prognosis of early-onset Alzheimer's is unfavorable.. These people deteriorate more rapidly than the elderly and the cognitive decline is more marked and evident. However, it is important to always focus on the skills that the patient retains and that he/she can still take advantage of and use them as long as possible.