How to identify early onset Alzheimer's: Signs, Symptoms, and Diagnosis

While many associate Alzheimer's with older age, an estimated 200,000 Americans live with early onset, developing symptoms before age 65.

This guide explains how to identify early onset Alzheimer's by recognizing the subtle yet significant early warning signs.

Quick Summary

Early onset Alzheimer's manifests through subtle memory lapses, changes in problem-solving ability, and shifts in mood or personality. Recognizing these symptoms requires attention to persistent behavioral and cognitive changes that interfere with daily life, warranting a professional medical evaluation.

Key Points

• Subtle Memory Lapses: The earliest signs often include more than simple forgetfulness, such as repeating questions or forgetting recently learned information.

• Behavioral Changes: Mood swings, increased anxiety, or uncharacteristic suspicion can be key indicators in early onset cases.

• Daily Task Difficulty: Look for struggles with routine activities like managing finances, following a recipe, or driving familiar routes.

• Diagnostic Process: A diagnosis relies on a full medical history, cognitive tests, and may include advanced brain imaging or biomarker analysis.

• Act Promptly: Early intervention is crucial for managing symptoms and planning for the future, so don't delay a professional consultation.

Recognizing the 10 Warning Signs

Symptoms of early onset Alzheimer's are often the same as those for late-onset, but they appear in people younger than 65. Being aware of these signs is the first step toward seeking a diagnosis.

1. Memory loss that disrupts daily life. This is more than just forgetting a name or where you put your keys. It involves forgetting recently learned information, important dates or events, or repeating the same questions over and over. A person may increasingly rely on memory aids or family members for things they once handled independently.

2. Challenges in planning or solving problems. A person with early onset Alzheimer's may find it difficult to follow a familiar recipe, keep track of monthly bills, or concentrate on a task. They may take significantly longer to do things they could do easily before.

3. Difficulty completing familiar tasks. This can manifest at home, at work, or during a favorite hobby. For instance, an avid bridge player might forget the rules of the game, or a talented cook might struggle with following the steps of a beloved recipe.

4. Confusion with time or place. Individuals may lose track of dates, seasons, or the passage of time. They may forget where they are or how they got there, even in familiar places.

5. Trouble understanding visual images and spatial relationships. This could cause difficulty with balance, judging distances, or discerning color or contrast. For some, this can lead to issues with driving or navigating stairs.

6. New problems with words in speaking or writing. The person may have trouble following or joining a conversation, repeating themselves, or struggling with vocabulary. They might call things by the wrong name.

7. Misplacing things and losing the ability to retrace steps. A common sign is putting items in unusual places, like car keys in the microwave. They may accuse others of stealing because they can't remember misplacing the item.

8. Decreased or poor judgment. Changes in judgment can lead to poor financial decisions, such as giving money to telemarketers, or neglecting personal grooming and hygiene.

9. Withdrawal from work or social activities. A person may start to pull away from hobbies, social engagements, or work projects due to changes they are experiencing. They may feel self-conscious or have trouble following conversations.

10. Changes in mood and personality. Someone might become uncharacteristically confused, suspicious, depressed, fearful, or anxious. They may become easily upset in situations that were once comfortable.

Early Onset vs. Late-Onset Alzheimer's

While the symptoms are similar, early onset can sometimes present with different primary symptoms initially. A comparative table can help highlight these distinctions.

Feature	Early Onset Alzheimer's	Late-Onset Alzheimer's
Age of Onset	Typically begins between ages 30s and mid-60s.	Occurs after age 65.
Early Symptoms	Often presents with non-memory symptoms, such as language difficulties, visual-spatial issues, or behavioral changes, before memory loss becomes prominent.	Memory loss that disrupts daily life is the most common and prominent early symptom.
Genetics	More likely to be linked to genetic mutations in a smaller number of familial cases.	Largely considered sporadic, with a complex interplay of genetic and lifestyle factors.
Misdiagnosis Risk	Higher risk of initial misdiagnosis, as symptoms may be mistaken for stress, depression, or other conditions.	The diagnosis is often more straightforward due to the typical age of onset.
Progression Speed	The progression rate can vary widely among individuals.	Progression can also vary, but the overall pattern is more predictable.

The Diagnostic Process

Diagnosing early onset Alzheimer's involves a thorough medical evaluation to rule out other causes of cognitive decline. This process typically includes several steps:

1. Medical History and Evaluation

A doctor will review your overall health, current medications, and family medical history. It's helpful to have a family member or friend present to describe the changes they've observed, as the person with symptoms may not be aware of them.

2. Cognitive and Neurological Tests

• Mental Status Tests: Brief, in-office tests that evaluate memory, problem-solving, attention, and language skills.
• Neurological Exam: Checks reflexes, muscle tone, coordination, balance, and senses to rule out other neurological conditions.

3. Lab Tests

Blood and urine tests are often conducted to rule out other potential causes of cognitive decline, such as thyroid problems, vitamin deficiencies, or infections.

4. Brain Imaging

• MRI or CT Scans: These images can help rule out other conditions like strokes, tumors, or fluid buildup.
• PET Scans: These advanced scans can detect amyloid plaques and tau tangles, the key biomarkers of Alzheimer's, in the brain.

5. Advanced Biomarker Testing

• Cerebrospinal Fluid (CSF) Analysis: A spinal tap can measure levels of amyloid and tau proteins in the CSF.
• Blood-Based Biomarkers: Newer blood tests are being developed to detect biomarkers, offering a less invasive option to support a diagnosis.

What to Do When Symptoms Appear

If you or a loved one are experiencing persistent symptoms, the most important step is to seek a professional medical evaluation. It's crucial not to ignore the signs, even if they are subtle. Early and accurate diagnosis allows access to treatments that may manage symptoms and provide support for both the individual and their family.

Here are some steps to take:

• Schedule a Doctor's Appointment: Start with a primary care physician, who can then refer to specialists like neurologists or geriatricians.
• Prepare for the Appointment: Make a list of all symptoms, including when they started and how often they occur. Write down a medical history and a list of all medications.
• Don't Go Alone: Bring a close family member or friend who can help describe the symptoms, as they might provide information the person with symptoms can't remember or recognize.

For more resources and guidance, the Alzheimer's Association is a leading authority on Alzheimer's disease: Alzheimer's Association.

Conclusion

Early onset Alzheimer's is a challenging diagnosis, but recognizing the signs and seeking help promptly is paramount. While memory loss is a hallmark, other cognitive and behavioral changes can be equally important, especially in younger individuals. A comprehensive evaluation by a medical professional can provide clarity, allowing for appropriate management, treatment, and planning. Understanding how to identify early onset Alzheimer's is the first step toward managing the disease and empowering those affected to live their best possible lives.

Frequently Asked Questions

What is the key difference between early and late onset Alzheimer's?

The key difference is the age of onset. Early onset occurs before age 65, sometimes as early as the 30s, while late onset typically appears after 65.

Can early onset Alzheimer's be genetic?

Yes, in a minority of cases, early onset Alzheimer's is caused by specific genetic mutations. These are often known as familial Alzheimer's disease (FAD).

What if I notice signs in a loved one but they are in denial?

Approach the conversation gently and with compassion. Frame it as a general health check-up, mentioning your concerns about specific changes you've observed. Encourage them to see a doctor for a full evaluation.

Are there specific tests to diagnose early onset Alzheimer's?

There is no single definitive test. Diagnosis involves a combination of a medical history, cognitive and neurological exams, lab work, and potentially brain imaging to rule out other conditions and identify biomarkers.

Do symptoms of early onset Alzheimer's always involve memory loss first?

No. Unlike typical late-onset cases, early onset can sometimes present first with more subtle non-memory symptoms, such as language problems or visual-spatial issues. Memory loss may develop later.

How is early onset Alzheimer's managed?

Management involves a comprehensive care plan, often including medication to help manage symptoms, supportive therapies, and lifestyle adjustments. Early diagnosis allows for earlier intervention and better planning.

Should a person with early onset Alzheimer's stop working?

This depends on the individual and the progression of their symptoms. Many can continue working for a time with appropriate support and adjustments. A doctor and a care team can help make this decision.