Epidemiology Of Early Onset Dementia And Its Clinical Presentations In The Province Of Modena Italy
U.O. di Neurologia, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
Centro Interdipartimentale di Neuroscienze e Neurotecnologie, Università di Modena e Reggio Emilia, Modena, Italy
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
Centro Interdipartimentale di Neuroscienze e Neurotecnologie, Università di Modena e Reggio Emilia, Modena, Italy
Dipartimento di cure primarie, AUSL Modena, Modena, Italy
NeuroFARBA, Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino, Università degli Studi di Firenze, Italy
U.O. di Neurologia, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
Centro Interdipartimentale di Neuroscienze e Neurotecnologie, Università di Modena e Reggio Emilia, Modena, Italy
U.O. di Neurologia, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
Centro Interdipartimentale di Neuroscienze e Neurotecnologie, Università di Modena e Reggio Emilia, Modena, Italy
Correspondence
Risk Factors For Early
Approximately 12% of cases of early-onset Alzheimers are due to a rare genetic mutation leading to an inherited form of the disease called familial Alzheimers. Individuals with Downs syndrome are also more likely to develop early-onset Alzheimers since the chromosome associated with the syndrome also carries the gene for amyloid .
A small percentage of early-onset dementia cases can be linked to a genetic form of vascular dementia or damage to the frontal lobes of the brain that control language, emotions, and behavior.
Younger people are believed to develop rarer forms of dementia at a much higher rate than older adults. As many as 25% of early-onset dementia cases are believed to be due to rarer causes, including degenerative neurological conditions like Huntingtons disease, progressive supranuclear palsy, or Creutzfeldt-Jakob disease.
You Struggle To Recall What You Just Read
Most dementia symptoms will have an affect on your memory, in some way, shape, or form. So it makes sense it can impact your ability to read â and remember what you just read â as well.
As Zerling says, many people with early-onset dementia find that they need to start taking notes while theyre reading, in order to remember whats going on in the story.
Taking notes, of course, can be a good way to keep track or information, especially if youre studying. And thus it isnt a surefire sign of dementia. But if your note-taking is due to a newly developed memory problem, it may a symptom worth looking into.
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Vascular Dementia With Early Onset
Cerebrovascular disorders are age-related processes. Therefore, VaD, or vascular cognitive impairment, usually occurs patients of senile age and less frequently in patients of presenile age. Clinically, executive functions are usually impaired in the early stage of the illness. Conversely, disturbance of short-term memory sometimes is not evident until an advanced stage of the disease. Pathologically, diffuse cerebral changes caused by vascular disorders, such as multiple infarctions and white matter degeneration of Binswanger type, are characteristic findings of VaD. The pathological and clinical features of VaD with an early onset essentially do not differ from those of VaD with a later onset.
However, genetic abnormalities facilitate the onset of cerebrovascular disorders, which cause VaD. Hereditary VaD occurs in middle age or in patients of presenile age. Occasionally, cases of Binswanger disease with early onset are due to hereditary disorders with genetic abnormalities of Notch3, namely cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoenceopathy. This disorder is characterized by onset in middle age, autosomal dominant heredity, and hemicrania. Pathologically, it is characterized by multiple microinfarctions, diffuse leukopathies of Binswanger type, hypertrophies of medial tissue in the cerebral perforant and meningeal arteries, and eosinophilic inclusions.
What Is The Difference Between Early
In 1901, 51-year-old Auguste Deter sat in her room, anxiously looking around. Her new doctor, Alois Alzheimer, was asking her to identify mundane objectsbut for some reason she couldnt remember which ones she had already named.
Notes from this initial meeting paint a vivid picture of her condition, now called Alzheimers disease. More than 100 years later, it would be reclassified as early-onset Alzheimers disease. Deter is one of modern medicines most famous patients, but few people recognize her particular form of Alzheimers. So, how are early and late-onset Alzheimers different?
Before we dive in, lets see what you know with a pop quiz.
What are the differences between early and late-onset Alzheimers disease?
- Early and late-onset Alzheimers have mostly the same symptoms however, early-onset develops before age 65 and late-onset develops after age 65.
- Early-onset comes in two forms, either familial or sporadic while Late-onset is sporadic.
- One form of Early-onset Alzheimers can be caused by variants in the APP, PSEN1, or PSEN2 genes. Late-onset Alzheimers disease is linked to a number of variants with the most well-known occurring in the APOE gene.
Think you found the right answer? Continue reading to find out .
Additionally, researchers have found variants in numerous genes that can be analyzed together to try to improve accuracy when predicting a persons odds of disease development based on their genetics.1,3,4
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Toxic Burden And Brain Health
Due to increased toxic burden from endocrine disrupting compounds, heavy metals, and other environmental contaminants, the bodys natural detox pathways have a significant amount of unwanted substances to properly metabolize and eliminate from the body.
If you have reduced methylation status, it can be even harder for your body to get rid of toxins, and this can cause things like heavy metals or other neurological toxins to interfere with brain health.
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You Suddenly Despise Any Kind Of Change
When dementia sufferers are experiencing confusion and memory changes, its common for them to stick to a strict routine, as a way to coping and feeling safer.
Thats why, as Dr. Scott Schreiber tells Bustle, a lack of desire to try something new, or to deviate from your usual path, may be a sign of memory changes.
This might take the form of sticking to the same route on your way to work, or taking the same streets to get to the grocery store. But its not just about the routine â since many people have a preferred way of getting places â but the reasons why youre always following the same path.
If you get confused when going another way, for example, or feel incredibly disoriented when deviating from your usual path, theres a chance its an early warning sign of dementia.
Symptoms In The Later Stages Of Dementia
As dementia progresses, memory loss and difficulties with communication often become severe. In the later stages, the person is likely to neglect their own health, and require constant care and attention.
The most common symptoms of advanced dementia include:
- memory problems people may not recognise close family and friends, or remember where they live or where they are
- communication problems some people may eventually lose the ability to speak altogether. Using non-verbal means of communication, such as facial expressions, touch and gestures, can help
- mobility problems many people become less able to move about unaided. Some may eventually become unable to walk and require a wheelchair or be confined to bed
- behavioural problems a significant number of people will develop what are known as behavioural and psychological symptoms of dementia. These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations
- bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence
- appetite and weight loss problems are both common in advanced dementia. Many people have trouble eating or swallowing, and this can lead to choking, chest infections and other problems. Alzheimers Society has a useful factsheet on eating and drinking
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Why Are Cases Of Early Onset Dementia And Alzheimers Increasing
In the U.S., its estimated that about 200,000 people have early onset dementia, either early-, middle- or late-stage dementia. Alzheimers diagnosis rates increased 200% between 2013 and 2017 in people aged 30 to 64. This resulted in the average age of 49 in someone living with the early onset of this neurodegenerative condition .
Early onset dementia is a difficult road because many patients often have families to provide for, and are frequently caregivers themselves to someone living with chronic illness. Alzheimers and dementia also disproportionately impact women more so than men. Its clear that proper Alzheimers support can help anyone cope with these difficulties.
Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
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Confusion About Location And Time
The person may experience confusion about places or times. They may have difficulty keeping track of seasons, months, or times of day.
They may become confused in an unfamiliar place. As Alzheimers disease progresses, they may feel confused in familiar places or wonder how they got there. They may also start to wander and get lost.
Frequently Misplacing Items And Not Being Able To Retrace Steps
Most people will lose items at some time, but they are usually able to locate them again by searching in logical locations and retracing their steps.
However, someone with Alzheimers disease may forget where they placed an item, especially if they put it in an unusual place. They may also be unable to retrace their steps to find the missing item. This can be distressing and may cause the person to believe that someone is stealing from them.
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Dementia With Lewy Bodies
Dementia with Lewy bodies is caused by the build-up of tiny protein deposits in the brain. DLB is less common in younger people with dementia than in older people. Lewy bodies also cause Parkinsons disease and about one-third of people with Parkinsons eventually develop dementia.Symptoms of dementia with Lewy bodies can include hallucinations and varying levels of alertness. People can also develop the features of Parkinsons disease .
What is dementia with Lewy bodies?
Find out more about dementia with Lewy bodies, diagnosis and how to treat it.
Memory Loss Is Normal Alzheimers Is Not
Alzheimers is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, leading to cognitive impairment that severely affects daily living. Often the terms Alzheimers and dementia are used interchangeably and although the two are related, they are not the same. Dementia is a general term for the loss of memory or other mental abilities that affect daily life. Alzheimers is a cause of dementia, with over 70 percent of all dementia cases occurring as a result of Alzheimers.
The majority of Alzheimers cases occur in people aged 65 years or older.
Slight memory loss is a normal consequence of aging, and people therefore should not be overly concerned if they lose their keys or forget the name of a neighbor at the grocery store. If these things happen infrequently, there is scant reason to worry. You most likely do not have Alzheimers if you simply forgot one time where you parked upon leaving Disneyland or the local mall during the holidays.
How do you know when forgetfulness is part of the normal aging process and when it could be a symptom of Alzheimers? Here are 10 early signs and symptoms of Alzheimers disease.
A key point to consider is whether these symptoms significantly affect daily living. If so, then Alzheimers disease might be the cause.
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The Quiet Early Signs Of Dementia And What You Can Do About Them
Research suggests there could be a link between hearing loss and Alzheimers here are other symptoms to look out for
One of the key ways to lower your risk of getting dementia is by looking out for this early signs that signal the syndrome which is related to the ongoing decline of the brains functions.
Its well known that memory loss and confusion are a sign of dementia. But scientists are discovering that other subtle and perhaps surprising signs can herald the onset of the disease.
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Disorientation
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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Early Symptoms Of Dementia
Although the early signs vary, common early symptoms of dementia include:
- memory problems, particularly remembering recent events
- increasing confusion
- apathy and withdrawal or depression
- loss of ability to do everyday tasks.
Sometimes, people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of the ageing process. Symptoms may also develop gradually and go unnoticed for a long time. Also, some people may refuse to act, even when they know something is wrong.
What Are The Symptoms Of Younger Onset Dementia
The symptoms of dementia are similar no matter what age they start. They include:
- memory loss that interferes with daily life
- confusion
- withdrawing from friends and family
- losing the ability to think clearly or make judgements
- language problems
- changes to behaviour
Many conditions can produce symptoms that are similar to dementia, such as vitamin and hormone deficiencies, depression, medication, infections and brain tumours.
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What Are The Causes Of Young
The causes of young-onset dementia are similar to the diseases that usually cause dementia in older people. However, some causes, such as frontotemporal dementia , are more common in younger people. Dementia in younger people often has different symptoms, even when its caused by the same diseases as in older people.There is more information about some common causes of dementia, and how they can affect younger people, below.
Living With Young Onset Dementia
Each person’s experiences and responses to dementia will be different and are likely to change over time. Find out what kind of support and assistance a person needs: talk to them and their family about what it is theyd like to do or achieve. Physical health is important: encourage regular exercise and remind people to go for their health checks and screenings. Help people find and engage in an activity that is meaningful to them.
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Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the persons very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
Finding A Huge Gap In Services And Supports For Younger People
âI unfortunately ran into that brick wall where I was ineligible for just about everything because of my age.â â Faye.
Most social programs and services are designed for older people with dementia. In comparison, the number of programs designed for people living with young onset dementia is sparse.
People living with young onset dementia may not find the programs intended for older adults interesting or beneficial in respect to their needs. They may not feel comfortable in a seniorsâ program. And even if they were interested and comfortable in joining a program, they might be ineligible because of their age!
We have a gap in our knowledge about young onset dementia. As a result, there simply aren’t enough information, support, financial aid and services adapted for younger people living with dementia.
However, this is changing. The Young Onset Gap Analysis Project, initiated through the National Information Support and Education Committee and the Alzheimer Society of Canada , explored the gaps of available learning and support resources for people living with young onset dementia, and sought advice and feedback from those with lived experience.
The information from this report is being used to develop new resources dedicated to education and support for people living with young onset dementia, families, caregivers and healthcare providers.
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