Early-onset Alzheimer's disease in your 20s? Experts weigh in
What is Early-Onset Alzheimer's disease?
Alzheimer's disease is the most common type of dementia, typically associated with memory loss and cognitive decline. Early-onset Alzheimer's, or younger-onset Alzheimer's, is diagnosed before the age of 65 and accounts for 5–8% of all Alzheimer's cases, according to Dr Abhas Kumar, consultant neurologist at RJN Apollo Spectra Hospital, Gwalior. While cases in very young adults (such as those in their early 20s) are extremely rare, the condition involves progressive neurodegeneration triggered by abnormal protein accumulation in the brain.
'These deposits disrupt communication between nerve cells, causing inflammation and oxidative stress,' explains Dr Neha Kapoor, associate director and Head of Neurology at Asian Hospital, adding, 'The hippocampus, which is essential for memory formation, is often the first region affected. As the disease progresses, it spreads to the cerebral cortex, impacting language, reasoning, and behaviour.'
What causes it?
While Alzheimer's can occur sporadically, early-onset cases tend to have a stronger genetic component. 'It may run in families, though having a family history doesn't guarantee inheritance,' says Dr Kumar, 'Certain rare genetic mutations, especially in the APP, PSEN1 and PSEN2 genes, can increase the risk significantly if passed down from a parent.'
Early signs
The early signs of EOAD (Early-Onset Alzheimer's Disease) are often subtle and easily mistaken for stress, burnout or the natural effects of ageing. 'These may include difficulty concentrating, forgetting recent events, struggling to plan or organise tasks, or frequently misplacing items,' says Dr Bhaskar Shukla, Consultant Neurologist at PSRI Hospital, adding, 'Personality changes, increased irritability or social withdrawal can also be red flags.' Interestingly, EOAD often progresses more aggressively than the late-onset form. 'Younger patients may experience language difficulties, visual-spatial issues or mood disturbances earlier in the disease. Job performance and handling complex tasks may also become more difficult, leading to misdiagnosis or delayed detection,' Dr Shukla adds.
Diagnosis, detection
Diagnosing EOAD requires a multi-layered approach involving cognitive assessments, neurological exams and advanced imaging tools. 'MRI and CT scans are used to rule out other conditions, while PET scans and cerebrospinal fluid analysis can detect hallmark signs like amyloid plaques and tau protein buildup,' says Dr Shukla. In cases with a strong family history, genetic testing may also be advised.
How can it be managed?
While there is no cure for Alzheimer's, early intervention can help improve quality of life. Dr Neha Kapoor outlines a comprehensive management plan:
Medication can slow disease progression or manage symptoms.
Structured cognitive stimulation and occupational therapy help maintain mental function and daily living skills.
Regular physical activity and diets like the Mediterranean or MIND diet support overall brain health.
Support groups and counselling provide emotional and psychological support for both patients and caregivers.
Tech-based tools such as memory aids and tracking apps can assist with daily routines.
A multidisciplinary approach, involving neurologists, therapists, psychologists, and caregivers, offers holistic care and greatly enhances disease management.
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