Young-onset dementia – what is it?
Dementia in older adults is attributed to a decline in memory and sensory perception and is slightly less unusual than say, someone in their 30s, 40s, or 50s. Dementia in younger adults is especially traumatic and challenging to acknowledge, and many practicing physicians fail to recognise it or even suspect it may be an underlying cause of symptoms.
Data shows that while most of the 5.3 million Americans who are living with Alzheimer’s disease or other forms of dementia are over 65, some 200,000 are younger than 65 and develop serious memory and thinking problems far earlier in life than expected. Many of the afflicted are in still their prime.
The diagnosis of young-onset dementia, according to neurologist Dr. David Knopman, Mayo Clinic in Rochester, Minnesota, is often delayed, and knowledge about its management is limited. Dr. Knopman cited a Dutch study that found that early-onset Alzheimer’s was a less likely explanation for young-onset dementia than two other causes – vascular dementia and frontotemporal dementia.
Vascular dementia results from a blockage or injury to blood vessels in the brain that interfere with circulation and deprive the brain of oxygen and nutrients. Its most common symptoms, in addition to memory problems, are confusion, difficulty concentrating or organising thoughts or tasks, and slowed thinking.
In frontotemporal dementia, which often begins between 40 and 65 years and is often misdiagnosed as a psychiatric problem, portions of the brain that lie behind the forehead and ears shrink, resulting in dramatic personality changes, socially inappropriate or impulsive behaviour, and emotional indifference. Movement and memory problems typically develop later along the course of the disease.
[Alzheimer’s disease patients typically have a buildup of abnormal substances – tau and beta-amyloid proteins – in the brain. The development includes symptoms such as impaired memory, language problems, difficulty concentrating and finishing tasks, poor judgment, and visual or spatial deficits. But while there is an inherited form of Alzheimer’s that typically arises at younger ages (10%) most cases occur sporadically and may be influenced by genetic factors.]
According to Dr. Knopman, a detailed medical history should help with accurately diagnosing young-onset dementia such as a glucose PET scan can uncover abnormal patterns of sugar uptake in various parts of the brain that can help distinguish between different degenerative brain diseases. The neurologist also recommends a brain scan to rule out the possibility that a tumour is behind problematic cognitive symptoms; a spinal tap and analysis of the spinal fluid can reveal elevated levels of tau and beta-amyloid proteins in the brain; while an MRI can depict shrinkage in specific parts of the brain.
A thorough cognitive assessment of the person’s memory and language difficulties is critical, he added. Neuropsychological tests can detect subtle difficulties with memory, visual, cognitive and executive functions.
As with older dementia patients, it’s essential to keep young people with dementia safe. They should no longer drive, operate dangerous equipment, including the stove, or be left alone. All should wear an identifying tag day and night that alerts others to their condition.
Read: Different risks of overactive bladder with different dementia medications
