Alzheimer's in young people: causes, symptoms and treatment
Alzheimer's disease, a devastating neurodegenerative disorder for the life of those who suffer from it and those around it, manifests itself very frequently in old age. However, it's not always like that. Although it is not as frequent, can appear before the age of 65 and even during early adulthood . In fact, the first presentation of the disease is described in the case of a 55-year-old woman.
There are some reasons to believe that Alzheimer's disease that occurs in old age and that manifested during adulthood, although they share many characteristics, could actually be variants of the same clinical entity. How does this disease appear and how can we detect it in time, then?
Characteristics of Alzheimer's disease
The objective of the article is not to make an exhaustive definition of the classic presentation of Alzheimer's, but it is necessary to refresh the memory and remember which are the most characteristic symptoms of Alzheimer's disease.
Alzheimer's in old age
The most common clinical presentation is the loss of episodic memory, which is accompanied by a progressive deterioration of other cognitive domains as voluntary movements or the capacity to produce and understand language. This definition is not rigid, since many other cases present a focal alteration of only one of the domains without memory impairment. Therefore, when we talk about Alzheimer's disease we are talking about a very heterogeneous group of presentations that all have the same cause.
At the cerebral level, we observed the formation of senile plaques and neurofibrillary tangles. The plates are no more than deposits of peptides that are formed with aging. It is common to have these plaques even in healthy adults, but we found a greater number of them in patients with Alzheimer's disease. The neurofibrillary tangles, on the other hand, are hyperphosphorylated conglomerates of tau protein. Its presence in the brain is also a predictor of neurocognitive disorder.
Alzheimer's in young adulthood
About 4% of Alzheimer's patients are diagnosed before age 65 . The most frequent form of Alzheimer's onset in young age is not through memory loss, but through non-amnesic syndromes. For example, visuospatial dysfunctions, apraxia, anomias, etc. Thus, we will find that executive, visuospatial and motor functions are usually affected in these patients, confusing the diagnosis with other disorders.
At the brain level, like its larger analogs, these patients also have a greater number of senile plaques and neurofibrillary tangles . However, its location is different. In young adults who develop Alzheimer's disease, the hippocampus is preserved and free of involvement by these deposits. Recall that the hippocampus is a cardinal point in the acquisition and recovery of memory. This finding explains to a large extent the difference in presentations, why in the elderly memory is affected from a good start and why in young people with Alzheimer's this is infrequent.
The neuropathology shows that there is a greater density and a more diffuse distribution of the typical signs of Alzheimer's. Structural neuroimaging studies show that the cortex is more affected than in elderly patients and also more diffuse, especially affecting the neocortex.
Taking all this evidence into account, it is possible to affirm 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 elderly patients. The lesions are distributed differently, so we could be talking about two variants of the same disease, not just a temporality criterion.
Causes of Alzheimer's in young people
In Alzheimer's that occurs in old age, the disease occurs due to the formation of natural deposits. The older the patient is, the more likely it is that they have so many waste deposits that they begin to worsen their cognitive abilities. Also, the lifestyle of each one can protect or not the formation of said deposits present in the disease.
But nevertheless, 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 Alzheimer's cases that start at an early age occur due to mutations in the genes that allow protein deposits to accumulate and senile plaques to form.
Instances of Alzheimer's due to mutations that are transmitted genetically are rare.It is believed that most cases occur by acquisition, or because the genes involved do not do their job optimally. It seems more the product of a cluster of genetic factors and lifestyles that produce oxidative stress than by a particular gene or marker. Naturally, those people who come from families with a marked history of Alzheimer's at a young age, if they wish, can undergo a test where they can find a marker of the presence of said genetic mutation or not and know if they will develop the disease.
Treatment and prognosis
The treatment of Alzheimer's in young people is the same as that prescribed for the elderly, with the advantage that they can perform more therapeutic activities than the latter It is very important to keep the activities of daily life as long as possible and not stop doing them for having been diagnosed. Autonomy and activities allow the individual to preserve their cognitive skills for much longer and the decline to be more gradual.
Cognitive stimulation through activities that use brain functions is a good protector against the progression of the disease. It is impossible to get rid of it or to stop it, for that reason the objective is to conserve the greater autonomy and possible quality of life during the greater period of time. It might be a good idea to make plans about how to manage life later when one begins to depend more on others and is unable to take issues such as the economy, legal procedures, will or will to certain medical procedures to which could be submitted one later.
The prognosis of Alzheimer's at an early age 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 can still take advantage of and pull them as long as possible.