Health Environmental And Lifestyle Factors
Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimers. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions, such as heart disease, stroke, and high blood pressure, as well as metabolic diseases, such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimers.
A nutritious diet, physical activity, social engagement, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimers. Researchers are testing some of these possibilities in clinical trials.
Memory Loss That Impedes Daily Activities
The most noticeable symptom of Alzheimers disease is often memory loss . A person may start forgetting messages or recent events in a way that is unusual for them. They may repeat questions, having forgotten either the answer or the fact that they already asked.
It is not uncommon for people to forget things as they get older, but with early onset Alzheimers disease, this happens earlier in life, occurs more often, and seems out of character.
Diminished Sense Of Smell
You used to be able to smell those fresh-out-of-the-oven chocolate chip cookies immediately, and now you hardly notice them. According to the National Institute on Aging, losing your sense of smell can be a symptom of Alzheimer’s, so it’s crucial to bring it up to your doctor if you notice any changes. Loss of smell and taste is also a symptom of coronavirus. And for more concerning COVID-19 signs, check out 13 Coronavirus Symptoms That Are More Common Than a Sore Throat.
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Duration Of Alzheimers Disease
The brain changes that result in Alzheimers disease may begin a decade or more before the first symptoms appear, as amyloid plaques and tau tangles start to form, neurons die, and other toxic changes in the brain begin to occur.
After diagnosis, a person with Alzheimers will live, on average, from four to eight years, though some survive for as long as 20 years, notes the Alzheimer’s Association.
When Dementia Strikes At An Early Age
Dementia in a person in their 30s, 40s or 50s poses special challenges, starting with getting a diagnosis.
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Many people arent overly concerned when an octogenarian occasionally forgets the best route to a favorite store, cant remember a friends name or dents the car while trying to parallel park on a crowded city street. Even healthy brains work less efficiently with age, and memory, sensory perceptions and physical abilities become less reliable.
But what if the person is not in their 80s but in their 30s, 40s or 50s and forgets the way home from their own street corner? Thats far more concerning. While most of the 5.3 million Americans who are living with Alzheimers disease or other forms of dementia are over 65, some 200,000 are younger than 65 and develop serious memory and thinking problems far earlier in life than expected.
Young-onset dementia is a particularly disheartening diagnosis because it affects individuals in the prime years, Dr. David S. Knopman, a neurologist at the Mayo Clinic in Rochester, Minn., wrote in a . Many of the afflicted are in their 40s and 50s, midcareer, hardly ready to retire and perhaps still raising a family.
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First Predominant Cognitive And Behavioral Symptom
The most commonly reported first predominant cognitive symptom was memory . For those who reported a first cognitive symptom the proportion of AD patients with a non-memory first predominant cognitive symptom gradually decreased with increasing age: < 60 years 26.1%, 60-69 years 19.8%, 70-79 years 10.5%, > 79 years 6.3%. In a logistic regression analysis combining all non-memory cognitive symptom domains the odds of a non-memory first predominant symptom was multiplied by 1.72 for each ten year decrease in age. Table 2 shows more detailed results from the multinomial logistic regression analyses that distinguished results for the non-memory symptom domains. Compared with memory, the odds of having judgment and problem solving, language and visuospatial problems as the first predominant cognitive symptom all increased with younger presentation age. These results remained largely unchanged when analyses were restricted to the AD subsets .
Age at first presentation and first predominant cognitive symptom
Percentages are given above colored bars for each symptom group where ⥠2%
Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
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Problems With Vision And Spatial Awareness
Alzheimers disease can sometimes cause , making it difficult for people to judge distances between objects. The person may find it hard to distinguish contrast and colors or judge speed or distance.
These vision problems combined can affect the persons ability to drive.
Typical aging also affects eyesight, so it is essential to have regular checkups with an eye doctor.
Is Alzheimers A Hereditary Disease That Runs In The Family
The answer is sometimes, but not always. Research has shown that youre more at risk for Alzheimers if you have a parent or sibling who had the disease. If you have more than one close relative with Alzheimers, youre even more at risk.
Butand this is importantbefore you start calling all your relatives to test for a genetic link to any health condition, its important to understand the word risk. Having relatives with Alzheimers, or with any particular disease, doesnt mean that you will also definitely get it, only that your risk is higher. And even if you are identified as having whats called a risk gene, it still only means your chance of developing the disease is increasedit does not guarantee that it will happen.
This is why doctors do not recommend genetic testing for the general population: people tend to misunderstand the results and assume that if a DNA test is positive for a risk gene, they will get the disease. Furthermore, the Alzheimers Association says that the at-home tests can have false-positive results, and they stress that home DNA tests should not be used as a substitute for a diagnostic examination by a skilled doctor.
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Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people. To learn more about clinical trials, watch this video from NIH’s National Library of Medicine.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
Be Open With Family And Friends
- Talk to your spouse and/or other close family members about your thoughts, fears, and wishes. Your family can help you plan for the future, including decisions about health care and legal and financial issues.
- Talk openly with children about your disease. Understand that they may be feeling concerned, confused, upset, or afraid. If appropriate, involve your children in discussions and decisions that affect the whole family.
- Your friends or neighbors might not know how to react to your diagnosis. They may feel like they dont know what to say or how to help, and may be waiting for you to make the first move. Invite friends to spend time with you. And dont be afraid to ask for help when you need it.
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Take Care Of Yourself
Your help is really important to your loved one’s quality of life. But it’s a lot to take on. You’ll probably feel anxious, depressed, and even angry sometimes. A person with dementia often needs long hours of care and a lot of monitoring, which can make you feel exhausted and overwhelmed. It’s OK to feel this way. Many caregivers do.
Don’t forget to take care of yourself. Here are some tips to relieve your stress:
- Be realistic. Accept that you can’t do it all alone and that it’s OK to ask for help or say yes when someone offers. It’s also fine to say no.
- Don’t quit your job until your loved one has a definitive diagnosis and you’ve fully explored any employee benefits. This helps keep income flowing and relieves stress about lack of funds, at least temporarily. Talk to your boss about flex options, like telecommuting.
- Stay informed. Learn all you can about early-onset dementia and how it can affect your family’s life. You’ll be better prepared for future changes.
- Talk to others. Get support from family and close friends. Don’t keep your feelings bottled up inside. Sharing your emotions and journey can be helpful. Caregiver support groups are available and may be a safe place for you to discuss your feelings and unwind.
- Walk it off. Exercise is a great stress reliever. It will help you sleep better, think better, and have more energy.
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Changes In Mood And Personality
Finally, as their Alzheimers progresses and becomes worse, people trying to cope with it can experience mood and personality changes that can be quite disturbing. They may become easily confused and suspicious of others, which can lead to depression and a near-constant state of anxiety and fearfulness.
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Early Onset Alzheimers: Yes You Can Get It In Your 30s
We tend to think of Alzheimers Disease as an affliction of the elderly, which is often true. But research suggests that the earliest stages of the disease often occur in people under the age of 65, and one study estimates that as many as 47 million Americans over the age of 30 show signs of the early preclinical form of the disease. While early-onset Alzheimers is still considered a rare diagnosis compared, the effects can be devastating to you and your loved ones.
The key to effectively dealing with early-onset Alzheimers is recognizing the signs as they begin to appear, especially in a relatively young patient. Unfortunately, the earliest signs of Alzheimers, such as mood changes or behavior, are often misdiagnosed as depression, anxiety, or other forms of mental illness. Misdiagnosis leads to ineffective treatment, and Alzheimers goes undetected until it is advanced, a situation that results in decades of suffering for the patient and his or her loved ones.
A Failing Sense Of Direction
A persons sense of direction and spatial orientation commonly starts to get worse with the onset of dementia. They may have difficulty recognizing once-familiar landmarks and forget how to get to familiar places they used to have no trouble finding.
It may also become more difficult to follow a series of directions and step-by-step instructions.
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What Are The Signs Of Alzheimer’s Disease
Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimers disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimers disease, people seem to be symptom-free, but toxic changes are taking place in the brain.
Damage occurring in the brain of someone with Alzheimers disease begins to show itself in very early clinical signs and symptoms. For most people with Alzheimersthose who have the late-onset varietysymptoms first appear in their mid-60s. Signs of early-onset Alzheimers begin between a persons 30s and mid-60s.
The first symptoms of Alzheimers vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers disease. Decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. And some people may be diagnosed with mild cognitive impairment. As the disease progresses, people experience greater memory loss and other cognitive difficulties.
Alzheimers disease progresses in several stages: preclinical, mild , moderate, and severe .
Variables Impacting Life Expectancy Calculations
Gender. Men dont live as long with Alzheimers as women. A study of more than 500 people diagnosed with Alzheimers disease between 1987 and 1996 found that women with Alzheimers live, on average, 20% longer than men. Age. Someone diagnosed at 65 lives an average of about eight years, while someone over 90 who gets a diagnosis typically lives about three-and-a-half more years. Strength of Symptoms at Diagnosis. If someone is showing especially severe dementia-related problems at the time of diagnosis, this usually leads to an earlier death. Someone who wanders, is prone to falling, and experiences urinary incontinence , will typically not live as long. A lower mini-mental state examination score at the time of diagnosis will also not live as long. Other Health Problems. A person with a history of heart problems or asthma or diabetes, for example, will not live as long as someone without those underlying issues.
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How Common Is Dementia In Adults Under 65
Dementia can affect people as young as 30, although this is extremely rare. Most younger people with dementia are middle aged: in their 50s and early 60s. The term young onset dementia, or ‘early onset dementia’, or ‘working life dementia’ refers to people diagnosed with dementia under the age of 65.
You cant have dementia, youre too young.
A GP quoted in an Alzheimers Society report
In 2010 there were thought to be 64,037 people under 65 with dementia in the UK compared with just 16,737 in 1998. The majority of those affected in this younger age group 70 per cent are men. Younger people with dementia make up 8 per cent of the total number of people with dementia .
The chances of developing dementia before 65 are relatively small. Men aged between 30 and 59 have a 0.16 per cent chance for women it is 0.09 per cent. The chances increase slightly once a person reaches 60. Men aged between 60 and 64 have a 1.58 per cent chance of developing dementia for women it is 0.47 per cent. The chances of developing dementia are highest for people between 90 and 94 .
Medications To Treat The Underlying Alzheimer’s Disease Process
Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.
Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.
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How Do I Treat Early
An important part of managing your condition is to stay as positive as you can. Keep up with the activities you still enjoy. Try different ways to relax, like yoga or deep breathing.
Keep your body in good shape, too. Make sure you eat healthy food and get regular exercise.
Medications can help with some symptoms of early-onset Alzheimer’s. Your doctor may prescribe drugs to help with memory loss, such as:
These medicines can delay or improve your symptoms for a few months to a few years. They may give you more time to live independently.
The doctor also may also suggest sleeping pills, antidepressants, or tranquilizers to manage other problems related to Alzheimer’s, like insomnia, night terrors, and anxiety.
Clinical Manifestations Of Eoad
In general, the clinical manifestation of AD is characterized by a predominant impairment of anterograde episodic memory. This symptom is typically accompanied by a multitude of cognitive impairments in domains, such as visuospatial, language, and executive function . The combination of the aforementioned characteristics contributes to a global cognitive decline, eventually leading to a total dependent state, and death . Although this typical clinical presentation of memory-predominant phenotypes overlaps between LOAD and EOAD cases, a subset of EOAD cases show an atypical presentation of preserved episodic memory function but focal cortical symptoms relating to language, visuospatial, or executive function . In 25% of EOAD cases, there is a distinct phenotype of non-memory symptoms, in particular apraxia, visual dysfunction, fluent or non-fluent aphasia, executive dysfunction, or dyscalculia, that is seen as the disease progresses . In addition, individuals with EOAD often present with a more aggressive disease progression and a shorter relative survival time , with the rate of progression driven at least in part by the nature of the underlying causative variant . EOAD cases have a greater pathological burden compared to LOAD .
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