Early-Onset Alzheimer's Disease

Imagine going home and seeing your father forget on how to tie his shoe, forgetting how to cook toast, or even solving a simple math problem and getting frustrated at himself for failing. You start to notice the signs of dementia, but you think he's only 50? You do some research and realize he has Early-Onset Alzheimer's. You take him to the doctor and find that it's all true. You're terrified and don't know how to help or even where to start.

What is Early-Onset Alzheimer's? “Early-Onset Alzheimer's is an uncommon form of dementia that strikes people younger than age 65” (Graff-Radford,2017). In Reference to the Alzheimer's disease genetics fact sheet, Alzheimer’s is caused by three different single-gene mutations on the chromosomes 1, 14, and 21. The mutations on each of these genes cause proteins to be formed. The mutation on chromosome 1 leads to abnormal Presenilin 2, mutations on chromosome 14 causes abnormal Presenilin to be made, and finally mutations on chromosome 21 cause the formation of abnormal amyloid precursor protein (APP) (NIH, 2015).

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When having Early-Onset Alzheimer's it's important to know the symptoms so you can start to recieve help. According to the Alzheimer's association some signs include memory loss that disrupts daily life this includes forgetting recently learned information. Another symptom is challenges in planning or solving problems, this includes learning recipes and working with numbers. Another symptom is difficulty completing familiar tasks at home, at work or at rest. Next is confusion with time or place, or even trouble with understanding visual images and spatial relationships. New problems with words in speaking or writing, misplacing things and losing the ability to retrace steps, decreased or poor judgement, changes in mood and personality, and finally withdrawn from work or social activities, It's important to know the signs of Early-Onset Alzheimer's to protect yourself and your loved ones.

Five percent of people who have Alzheimer's disease experience the symptoms before age 65. In America about 200,000 people have early-onset alzheimer's disease. The symptoms for early-onset would begin around your 40s and 50s (Graff-Radford, 2017). Early-onset affects those younger than age 65. Recent studies have shown that female Latinos and African Americans have a higher risk of early-onset alzheimer's. Hypertension, diabetes, strokes, and coronary artery disease are all risk factors for Alzheimer's. These conditions are more common in Latinos, and African Americans compared other Americans.(US Against Alzheimer's).

According to the U.S National Library of Medicine, Alzheimer’s is an autosomal dominant. This means that one copy of an altered gene in each cell is sufficient to cause the disorder. This usually occurs when an affected parent gives its offspring an altered gene (U.S National Library of Medicine, 2019).

Diagnosis is essential to truly figure out if you have early-onset Alzheimer's. According to the Alzheimer’s Association, you will need to be evaluated by someone who specializes in alzheimer’s. From there the diagnosis would consist of a medical exam, cognitive tests which test memory, language, skills, math, and problem solving skills. Neurological exam or brain imaging. Neurological exams asses balance, sensory response, reflexes and electroencephalogram which check for abnormal brain activity. The Alzheimer's Association states “keep in mind there is no one test that confirms Alzheimer’s disease. A diagnosis is only made after a comprehensive medical evaluation” (Alzheimer's Association,2019). Sometimes for early-onset genetic testing can show increased risk for early-onset. This gene is APOEe4 (Mayo Clinic Staff,2018).

What are the treatments for early-onset Alzheimer's? Well actually there is no cure Early-Onset Alzheimer’s or medication that could stop or slow the progression. However, ‘there are drug or non-drug options that may help treat the symptoms. Understanding available options can help individuals living with the disease and help improve quality of life.”(Alzheimer’s Association, 2019) One option is medications for memory loss. Drugs used to help early stages are cholinesterase inhibitors. These drugs are used to help treat symptoms for memory, language, thinking, judgement, and other thought processes. They also help prevent the breakdown of a chemical called acetylcholine, which is used as a messenger that is important for memory and learning that supports communication among nerve cells by keeping acetylcholine high. Other ways for treatment are behavioral medications and the use of caregivers. With the help of the Alzheimer’s Association some new promising targets for next generation drug therapies are being studied in recent investigations. The first one is Beta-amyloid and it is a chief component of plagues, one hallmark alzheimer's brain abnormality. Scientists have newly detailed information of how the protein fragment is clipped from its parent compound, APP, by two enzymes known as Beta-secretase, and Gamma-secretase. Together they form the Beta-amyloid protein, which is present in abnormally high levels in the brains of people with Alzheimer’s. Since the information is now known, researchers have began developing medications that are aimed at every point in the amyloid processing pathway. The current drug that targets Beta-amyloid is Aducanumab and it is a recombinant monoclonal antibody targeting aggravated forms of Beta-amyloid. Another enzyme that clips is Beta-secretase. Beta-secretase makes it possible for Beta-amyloid to form and with therapies, hopefully be able to reduce the amount of Beta-amyloid and interrupt development of Alzheimer’s. The drug for this is JNJ-54861911, and it inhibits the ability of Beta-secretase to make Beta-amyloid. There are many more treatments, drugs, and therapies being tested and researched in hopes of finding a cure. (Alzheimer's Association, 2019)

Alzheimer's disease was first discovered in 1906 by Dr. Alois Alzheimer. However, it is not known when the early form was first recognized. Dr. Alois Alzheimer first noticed changes in the brain tissue of a women who died of an unusual mental illness (NIH,2016). The cause of Early-Onset Alzheimer's is still unknown besides the genetic mutations on chromosomes 1,4,and 21. A new clinical study The Longitudinal Early-Onset Alzheimer's disease study. It is a non-randomized, natural history, non-treatment study that is designed to look and observe at the disease progression in individuals with Early-Onset cognitive impairment.

There are many organizations and support groups for those who are affected with Early-onset Alzheimer's. The Alzheimer's association has many resources for help.They have a 24/7 helpline, local offices and programs, education programs, social engagement programs, and online tools. Those were some support groups for those with Early-Onset but there are also some for the friends and family.Counseling, therapy, and support groups are essential to maintain a healthy mental health for friends and family of those who have Early-Onset Alzheimer's. Locally, here in Wichita kansas, the Alzheimer's association building hosta classes, groups, and will always be there to help.

Early-Onset Alzheimer's is rare in the united states compared to the common late Alzheimer's. As a result of Alzheimer's being so common there are some celebrities who had a form of dementia and Alzheimers. Rosa parks was diagnosed with dementia in her late years of life. Another famous person was Ronald Reagan. Regan was diagnosed with alzheimer's in 1994, only 5 years after leaving the office. Besides celebrities who had a form of demita, there were also some who helped promote the awareness. Seth Rogen lost his mother due to Early-Onset Alzheimer's. His mother was diagnosed in her 50s. After that Seth and his wife decided to create a charity called Hilarity for Charity. This charity was an educational campaign to teach younger people about Early-Onset Alzheimer's in hopes to reduce the stigma of it (Sauer,2016). Finally, to promote the disease, The Alzheimer's association plans and creates a walk for the awareness of Alzheimer's.

After finding out all of the information about Early-Onset you start to relieve your stress and know how to help your father. You learn about medications and therapies to help with the symptoms. You learn about the best way to help him and you learn more about how it's caused. You find support groups to help him and you finally, you understand what is happening and are able to take it all in.