Here’s What To Know About Early-Onset Alzheimer’s
Everyone experiences memory lapses, but here's what happens when it's serious.
Bill Gates recently announced he will invest $100 million
to help find a cure for Alzheimer’s disease. The degenerative brain
disease has struck several men in the billionaire tycoon’s family, as
well as around 5.5 million Americans.
“My
family history isn’t the sole reason behind my interest in
Alzheimer’s,” Gates wrote in his personal blog. “But my personal
experience has exposed me to how hopeless it feels when you or a loved
one gets the disease. We’ve seen scientific innovation turn
once-guaranteed killers like HIV into chronic illnesses that can be held
in check with medication. I believe we can do the same (or better) with
Alzheimer’s.”
As such, Gates is dropping half of the massive amount of dough into the Dementia Discovery Fund, a private group that is working on identifying new targets
for treatments and attempting to “diversify the clinical pipeline.” The
other $50 million is going to start-ups working on Alzheimer’s
treatments.
“There
are plenty of reasons to be optimistic about our chances: our
understanding of the brain and the disease is advancing a great deal,”
he wrote. “We’re already making progress—but we need to do more.”
Alzheimer’s
is categorized into three types: early-onset, late-onset, and familial.
More is known about late-onset and familial Alzheimer’s, although 13 percent of early-onset cases are familial.
Early-onset occurs in people who are younger than 65 and is rare,
accounting for only about 5 percent of the Alzheimer’s population. Those
with early-onset also experience more of the brain changes that come
with Alzheimer’s than those who develop it later on in life do.
Alzheimer’s Disease 101
Alzheimer’s
disease is most commonly known for its devastating ability to wipe out
the memory of those who have it. Over time, however, it will also damage
the person’s thinking skills, leaving them unable to perform even the
simplest tasks.
Discovered in 1906 by Dr. Alois Alzheimer, the condition also creates significant changes in a person’s brain.
“Two
abnormalities central to the disease are plaques and tangles,” says
Heather M. Snyder, PhD and Senior Director of Medical and Scientific
Operations at the Alzheimer’s Association.
“Plaques
are formed by clumps of beta-amyloid protein that interfere with
cell-to-cell communication in the brain. Tangles occur when tau protein
in the brain—a key component in the brain’s transport system—twist into
abnormal tangles, disrupting delivery of nutrients and other essential
materials within the brain.”
“Researchers
are working to better understand the precise role plaques and tangles
play in the disease and how to prevent or slow their development.”
The
damage begins in the hippocampus, the part of the brain that is
responsible for holding onto memories. Over time, and as more neurons
die, other parts of the brain are affected. Eventually, the brain can
experience significant shrinkage and prevent people from engaging in
simple tasks like eating.
Although
it is listed as the sixth leading cause of death in Americans, the
disease isn’t usually what kills. Rather, the complications that come
with the disease are thought to cause death. For example, a person who
is bedridden because of Alzheimer’s may develop a fatal blood clot.
Weight loss and other complications can result in a weakened immune
system, which can lead to problems that may end in death.
Symptoms of Early-Onset Alzheimer’s Disease
Alzheimer’s
is the most common type of dementia, a syndrome that includes a
combination of memory loss and the inability to perform simple tasks
that is so significant it affects a person’s daily life. Alzheimer’s
disease accounts for 60 to 80 percent of all dementia cases.
Early-onset
Alzheimer’s differs from late-onset and familial in that it typically
appears when a person is in their forties or fifties, as opposed to when
they’re 65. And although memory loss and confusion happen to even the
healthiest brains from time to time, it’s worrisome when it happens
progressively more than usual.
But it’s more than forgetfulness that is a cause for concern.
Other
symptoms of early-onset Alzheimer’s include trouble with time and
place, difficulty completing familiar tasks, challenges in planning and
problem solving, trouble speaking, misplacing things, withdrawal, and
decreased or poor judgment.
Who gets Alzheimer’s?
Unfortunately,
when it comes to Alzheimer’s, just about everyone is game. However,
genetics do play a factor. Your chances of getting Alzheimer’s, either
early-onset or late-onset, are increased if you have a parent or sibling
who is affected, says Snyder.
Familial
Alzheimer’s, however, is a whole different ball of wax. Just like
early-onset, familial Alzheimer’s is rare, affecting only about 2
percent of the Alzheimer’s population. It is the result of a mutation
that affects one to three genes that are known to aid in the development
of Alzheimer’s: PSEN1, PSEN2, and AAP. Those who have relatives with
familial Alzheimer’s are just about guaranteed to inherit the condition,
as well.
Alzheimer’s is also more prevalent in certain groups, and researchers aren’t sure why that is.
“Current
estimates indicate that African Americans are twice as likely to
develop the disease,” Snyder says. “Hispanics are one-and-one-half times
as likely. People living with Down’s syndrome are at higher risk, and
two-thirds of Americans with Alzheimer’s are women.”
Researchers
are currently examining what mechanisms and underlying biology may be
contributing to why the disease targets certain people, including
genetics, and variations in health, lifestyle and environmental risk
factors, she says.
Is genetic testing worth it?
Since
medical professionals have identified which genes affect Alzheimer’s,
it makes sense to wonder if genetic testing to determine if you will
develop the disease is beneficial. The problem is that the tests don’t
provide a definitive answer, says Snyder.
“Unless
a person has familial Alzheimer’s that guarantees Alzheimer’s (2
percent or fewer of all cases), a genetic test will only indicate if
someone is at greater or lower risk for the disease,” she says.
“The
Alzheimer’s Association cautions against routine genetic testing for
Alzheimer’s disease risk until an individual has received proper
counseling and understands the information necessary to make an informed
decision, including the social and economic factors that could be
impacted by having this genetic information.”
In
other words, you’ll need to ask yourself if finding out that you might
have a greater chance of developing Alzheimer’s than the next guy does
is worth the effect it may have on your life. Since you won’t receive a
definite answer of whether or not you’ll have the condition, it may not
be worth the what-ifs you’ll likely experience after receiving the
results.
After the Diagnosis
Receiving
a late-onset Alzheimer’s diagnosis isn’t a walk in the park. But
finding out you have early-onset Alzheimer’s is typically worse.
It’s life changing, not only for the person receiving the diagnosis but for their loved ones as well.
Those
with early-onset often begin experiencing symptoms while they are still
working. This can create problems that people who develop the condition
later on in life don’t usually have to worry about, says Snyder. They
may find it gets increasingly difficult to perform their duties at the
same level they did prior to the diagnosis and may also lose their jobs
because of it.
As
such, providing for their families, paying college tuition for
children, and keeping up with the mortgage can become a struggle,
particularly if the person with Alzheimer’s is the primary financial
provider for the family. Because they are younger, they may not have the
financial means to be able to retire. And since Alzheimer’s is a
progressive disease, it only gets worse and worse.
“It’s
life changing, not only for the person receiving the diagnosis but for
their loved ones as well,” Snyder says. “Following a diagnosis, it’s
important for the individual and family members to educate themselves
about the disease, available treatments, and care and support services
that can help navigate current and future challenges associated with the
disease, including the emotional aspects of coming to terms with a
diagnosis.”
And
although there isn’t currently a cure for Alzheimer’s, medications are
available that can help to manage the symptoms. Participation in trials
is also encouraged, as patients have access to treatment therapies that
are in development that they may not otherwise.
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