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Early Onset Dementia Signs and Symptoms

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Medical research conducted at the Mayo Clinic has discovered that the origins of early onset dementia are generally not due to Alzheimer’s disease by from autoimmune and neurodegenerative disorders, such as lupus, multiple sclerosis and Huntington’s disease. The study involved 235 subjects between 17 and 45 years old who had been clinically diagnosed with early-onset dementia. After analyzing each patient’s medical records, Mayo Clinic doctors found that less than two percent of the dementia subjects under 45 years old could attribute dementia signs to Alzheimer’s disease.

Frontotemporal dementia accounted for about one-third of the memory loss seen in the subject group, with another 20 percent suffering from inflammatory and autoimmune disorders. Slightly more than 10 percent were experiencing metabolic abnormalities that contributed to short term memory loss.  Consequently, doctors investigating early onset dementia  signs and symptoms affecting the remaining subjects could not establish a distinct cause for the disease.

 Familial Alzheimer’s Disease

Also called early onset familial Alzheimer’s disease, FAD is responsible for 50 percent of all early onset Alzheimer’s disease cases that usually affects people under 65 years old and older than 50. Caused by an inherited autosomal dominant gene that is passed among first degree relatives, FAD produces symptoms that are the same as traditional signs of Alzheimer’s disease, such as:

  • Routinely losing items that should not normally be misplaced (car keys, house keys, purses, etc)
  • Difficulty performing everyday tasks
  • Distinct personality changes (someone who is usually even-tempered might start acting irritable and contrary)
  • Executing poor judgment when faced with important personal and financial decisions
  • Confusion exacerbated by short term memory loss
  • Withdrawing from family and friends
  • Inability to complete a sentence or communicate rationally

Because early onset dementia primarily affects people who are in their late 40s and 50s, the level of physical disability is reduced in comparison to older patients suffering from signs of Alzheimer’s disease.

Genetics of Familial Alzheimer’s Disease

brain testA  mutation in the APP, or amyloid precursor protein gene, is thought to be the origin of FAD. Although research has uncovered a vast amount of valuable information regarding  Alzheimer’s dementia, neuroscientists still do not know the exact etiology of the disease and continue to focus on identifying early onset dementia genes.

Certain non-genetic factors have also been proposed to strongly influence the emergence of memory loss and other cognitive issues in FAD cases. These factors include:

  • Non-modifiable elements such as ethnicity, age, health condition at birth and early growth and development
  • Modifiable factors like socioeconomic level and medical issues (obesity, high blood pressure, diabetes
  • Degree of intellectual and physical enrichment that the patient’s environment provides

Although Alzheimer’s researchers are certain that environmental and health factors interact with genes to generate the “trigger” needed to express that gene, exploring the complexities of the gene-environment connection in Alzheimer’s disease is challenging and requires extensive longitudinal studies.

Clinical and Laboratory Testing for Early Onset Dementia

Receiving an accurate and timely diagnosis of FAD is critical to starting on medications as soon as possible to inhibit progression of the disease. In addition to undergoing a thorough cognitive and physical examinations, symptomatic and non-symptomatic patients can also participate in genetic testing that will distinguish the presence of genetic mutations indicative of Alzheimer’s.

Number 1, 14, and 21 chromosomal genes are correlated with early onset types of Alzheimer’s dementia. Individuals possessing mutations within these genes will in all likelihood develop AD before the age of 65. A fourth gene located on chromosome 19 (APOE-e4), is associated with the development of late-onset Alzheimer’s dementia in patients over 65 years old. Those who are found to have two copies instead of one copy of this gene may have a greater risk of experiencing Alzheimer’s in their later years.

People carrying these genetic mutations may not necessarily suffer from AD. Psychological and lifestyle modifications such as exercising regularly, eating a heart-healthy diet, engaging in stimulating intellectual activity and learning how to reduce stress may lower the risk of developing signs of Alzheimer’s disease.

 Non-Medical Problems of Familial Alzheimer’s Disease

 One of the primary problems unrelated to dementia symptoms that results from the progression of early onset dementia is the inability for someone who is not eligible for social security retirement income to continue working and earning a living. Although people with disabilities can file a claim with the Social Security Administration, they are often subjected to waiting up to two years before receiving benefits.

For people with early onset dementia, waiting that long for financial help is not  feasible. Some people may experience a steady and rapid decline following a diagnosis of FAD and find they can no longer work soon after learning of the diagnosis.

Fortunately, the U.S. Social Security Administration has recognized this growing problem and enacted the Compassionate Allowances program in 2008, which allows for expedited financial assistance in special circumstances, FAD being one of them. For more information about the Compassionate Allowances program, visit the Social Security Administration for instructions regarding rules and regulations governing the program.