Early Onset Alzheimer’s Disease

Most young people diagnosed with early onset Alzheimer’s disease have the condition for no known reason. But some people who experience early onset Alzheimer’s disease have the condition due to genetic causes. Researchers have been able to identify the genes that determine or increase your risk for developing Alzheimer’s.

Deterministic genes

One of the genetic causes is “deterministic genes.” Deterministic genes guarantee that a person will develop the disorder. These genes account for less than 5 percent of Alzheimer’s cases.

There are three rare deterministic genes that cause early onset Alzheimer’s disease:

• Amyloid precursor protein (APP): This protein was discovered in 1987 and is found on the 21st pair of chromosomes. It provides instructions for making a protein found in the brain, spinal cord, and other tissues.
• Presenilin-1 (PS1): Scientists identified this gene in 1992. It’s found on the 14th chromosome pair. Variations of PS1 are the most common cause of inherited Alzheimer’s.
• Presenilin-2 (PS2): This is the third gene mutation found to cause inherited Alzheimer’s. It’s located on the first chromosome pair and was identified in 1993.

Risk genes

The three deterministic genes differ from apolipoprotein E (APOE-e4). APOE-e4 is a gene that’s known to raise your risk of Alzheimer’s and cause symptoms to appear earlier. But it doesn’t guarantee that someone will have it.

You can inherit one or two copies of the APOE-e4 gene. Two copies suggest a higher risk than one. It’s estimated that APOE-e4 is in about 20 to 25 percent of Alzheimer’s cases.

Most people experience momentary memory lapses. Misplacing keys, blanking on someone’s name, or forgetting a reason for wandering into a room are a few examples. These aren’t definitive markers of early onset Alzheimer’s, but you may want to watch out for these signs and symptoms if you have a genetic risk.

The symptoms of early onset Alzheimer’s are the same as other forms of Alzheimer’s. Signs and symptoms to watch out for include:

• difficulty following a recipe
• difficulty speaking or swallowing
• frequently misplacing things without being able to retrace steps to find it
• inability to balance a checking account (beyond the occasional math error)
• getting lost en route to a familiar place
• losing track of the day, date, time, or year
• mood and personality changes
• trouble with depth perception or sudden vision problems
• withdrawing from work and other social situations

If you’re younger than 65 and experience these kinds of changes, talk with your doctor.

Keep reading: What are the signs of early onset Alzheimer’s? »

No single test can confirm early onset Alzheimer’s. Consult an experienced physician if you have a family history of early onset Alzheimer’s.

They’ll take a complete medical history, conduct a detailed medical and neurological exam, and review your symptoms. Some symptoms may also seem like:

• anxiety
• depression
• alcohol use
• medication side effects

The diagnostic process may also include magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain. There may also be blood tests to rule out other disorders.

Your doctor will be able to determine if you have early onset Alzheimer’s after they’ve ruled out other conditions.

Genetic testing considerations

You may want to consult a genetic counselor if you have a sibling, parent, or grandparent who developed Alzheimer’s before age 65. Genetic testing looks to see if you carry deterministic or risk genes that cause early onset Alzheimer’s.

The decision to have this test is a personal one. Some people choose to learn whether they have the gene to prepare as much as possible.

Don’t delay talking with your doctor if you may have early onset Alzheimer’s. While there is no cure for the disease, detecting it earlier on may help with certain medications and with managing symptoms. These medications include:

• donepezil (Aricept)
• rivastigmine (Exelon)
• galantamine (Razadyne)
• memantine (Namenda)

Other therapies that may help with early onset Alzheimer’s include:

• staying physically active
• cognitive training
• herbs and supplements
• reducing stress

Keeping connected with friends and family for support is also very important.

When younger people reach a stage that requires extra care, this may create the impression that the disease has moved faster. But people with early onset Alzheimer’s do not progress faster through the phases. It progresses over the course of several years in younger people as it does in adults older than 65.

But it’s important to plan ahead after receiving a diagnosis. Early onset Alzheimer’s can impact your financial and legal plans.

Examples of some steps that can help include:

• seeking out a support group for those with Alzheimer’s
• leaning on friends and family for support
• discussing your role, and disability insurance coverage, with your employer
• going over health insurance to ensure certain medications and treatments are covered
• having disability insurance papers in order before the symptoms appear
• engaging in financial planning for the future if a person’s health changes suddenly

Don’t be afraid to seek help from others during these steps. Getting personal affairs in order can provide peace of mind as you navigate your next steps.

There’s currently no cure for Alzheimer’s disease. But there are ways to medically manage the condition and live as healthy a life as possible. Examples of ways you can stay well with early onset Alzheimer’s disease include:

• eating a healthy diet
• reducing alcohol intake or eliminating alcohol altogether
• engaging in relaxation techniques to reduce stress
• reaching out to organizations like the Alzheimer’s Association for information on support groups and potential research studies

Researchers are learning more about the disease every day.

Read more: What are the stages of Alzheimer’s disease? »