November 4, 2011
More than a third of people with early-onset Alzheimer’s, a form of Alzheimer’s that typically occurs before age 60, do not have memory loss as their chief complaint, a new study reports. Instead, many have behavioral problems or problems with vision or language that raise red flags, and Alzheimer’s often goes undiagnosed in such patients.
Early-onset Alzheimer’s is rare compared to the late-onset Alzheimer’s that typically strikes after age 65. But the findings highlight the fact that although memory loss is the most prominent feature of Alzheimer’s, thinking and perception problems also typically afflict people with all forms of the disease. The study was published in Neurology, the medical journal from the American Academy of Neurology.
For the study, investigators in Barcelona, Spain, reviewed cases of 40 middle-aged people, ages 46 to 60, whose Alzheimer’s was confirmed on autopsy. Fifteen of them did not have memory loss, but had personality changes and acted erratically or had problems with vision or language or with carrying out day-to-day tasks.
More than half of those without memory problems were diagnosed by doctors as having a disease other than Alzheimer’s, often another form of dementia. By comparison, when memory problems were present, Alzheimer’s was almost always diagnosed.
“People who develop early-onset Alzheimer’s disease often experience these atypical symptoms rather than memory problems, which can make getting an accurate diagnosis difficult,” said study author Dr. Albert Lladó of the Alzheimer’s Disease and Other Cognitive Disorders Unit at the Hospital Clínic of Barcelona. The authors call for more accurate tests to detect Alzheimer’s early, so that proper treatments can be given.
Men and women with the far more common late-onset of Alzheimer’s disease that typically afflicts those in their 60s, 70s or older are more likely to have memory loss as one of their chief complaints than younger people with the disease. But it is important for doctors and family members to recognize that memory loss is not the only problem that affects those with Alzheimer’s. In some cases, behavioral problems can be treated with medications and other therapies.
Source: M. Balasa, M.D., E. Gelpi, M.D., Ph.D., A. Antonell, Ph.D., et al: “Clinical Features and APOE Genotype of Pathologically Proven Early-Onset Alzheimer’s Disease.” Neurology, Vol. 76, May 17, 2011, pages 1720-1725.