What Is Early Onset Dementia? Signs And Symptoms
Early onset dementia. Imagine you are at your friend’s 50th birthday gathering and you forget everyone’s name, how you got there and where you are? All these signs might be telling you that there is something wrong with your memory. If you are under 65 it might be early onset dementia, but what is it, what are the symptoms, can it be treated? Read this complete guide on early onset dementia.
What is early onset dementia?
It is a degenerative disease that causes a gradual deterioration of the brain cells. It is considered early onset or pre-senile if the symptoms appear before 65. Some even differentiate dementia that appears before 45 as young onset dementia.
“Dementia is a syndrome that implies not only a deterioration of memory and other cognitive functions but a change in behavior and the ability to carry-out basic everyday activities”. WHO (World Health Organization)
The cause of early onset dementia is Alzheimer’s Disease (43-58% of early onset dementia cases), followed by frontotemporal dementia (FTD). Vascular dementia, alcoholism, or head trauma are the most common causes when it comes to secondary etiology. However, young onset dementia (<45) are more often caused by FTD, and almost no cases caused by Alzheimer’s Disease.
Dementia is one of the main causes of disability and dependency in older adults, and its effects aren’t only devastating for the one suffering, but for family and loved ones as well. Dementia is a pretty common disease and generally appears after 65. An estimated 47.5 million people suffer from dementia, and each year 7.7 million new cases are reported. The majority of these cases are Alzheimer’s Disease (60-70%). However, while it is a disease generally related to aging, it can be early onset. Below, we will try to explain what is early onset dementia focusing on premature Alzheimer’s.
Early Onset Dementia-Clinical Symptoms
Patients with early onset dementia show more behavioral and psychological symptoms associated with dementia and less cognitive and functional deterioration than patients with late onset. The first symptoms of this disease are not the typical ones that will develop later.
In frontotemporal dementia, there is controversy surrounding the symptoms, where scientist dispute where or not they are different in early-onset cases or not. Some studies don’t see any differences and others find that late-onset dementia shows higher degrees of apathy, memory problems, and visual-spatial problems that early onset.
However, the differences between early onset dementia and Alzheimer’s Disease are clear (Check them here). Patient with early onset dementia tend to have more language problems, more difficulties in tasks that require sustained attention, and more psychological and behavioral symptoms.
Early onset dementia: Symptoms in Alzheimer’s patients
- Memory loss
- Difficulty Planning and Solving Problems
- Difficulty Completing Tasks
- Difficulty Determining Time and Place
- Vision Loss
- Misplacing Objects
- Difficulty finding words
- Personality and Mood Changes.
Early onset dementia: Symptoms associated with language disorders
- Anomie or difficulty finding the right word to call objects or explain an idea.
- Decrease of vocabulary
- Use of long and vague phrases to explain things. They use lots of unspecific words to describe things instead of using the right word, eg. thing, that, it…
- They take a while to get to the point, and they have a hard time finding the right words.
Early onset dementia: Symptoms related to sustained attention
- Difficulties concentrating: they might start having problems following a story line in a book or movie
- Math and calculations: they start to have difficulties when they’re shopping, calculating how much to spend, how much change they need to give…
Early onset dementia: Behavioral and psychological symptoms
- Apathy. No desire to do anything
- Depressive symptoms. Feeling sad or discouraged. It’s not uncommon for early onset patients to show more depressive symptoms. On a psychological level, the perception of a loss of independence is greater, because they feel obligated to stop their daily activities: working, driving, traveling independently… All of this impacts the patient’s self-esteem and self-worth.
- Anxiety symptoms. When the patient starts to be conscious of their deficits, it may cause anxiety. They will also face anxiety when learning how to deal with new situations related to the advancement of their disease.
- Irritability. Patients may be irritable to different degrees, like an annoyance to verbal or physical aggressiveness.
Early Onset Dementia- How will I get Diagnosed?
There are no set exams that will confirm if you have early onset dementia, however, doctors will check through several exams to see if it is a possibility.
The first thing your doctor will ask is about your medical history including current symptoms. She will test your memory and problem-solving abilities.
Neuroimaging is also a great asset in these cases. She will look at changes in your brain through a CT scan or X-rays. An MRI might also be a possibility depending on what the doctor considers appropriate.
What causes Early Onset Dementia?
Early Onset Dementia just like other dementia is caused by damage to brain cells. The damage interferes with the communication process between brain cells. Since the brain cells are not communicating properly, our behavior, cognitive processes, and feelings can be affected.
Different types of dementia are associated with particular types of brain cell damage in a specific brain part. In early onset dementia related to later Alzheimer patients, the hippocampus seems to be damaged first by the proteins keeping the brain cells from communicating with each other. Since the hippocampus is associated with memory the first symptom associated with early onset dementia is memory loss.
Treatment and Care for Early Onset Dementia
There is no specific cure for early onset dementia, however, there are drug treatments that might improve the symptoms temporarily. Medications will be assigned according to the different symptoms the patient might have.
Medications for Memory Loss: The person in this early onset dementia will be given Cholinesterase inhibitors to treat memory, language, judgment and other cognitive processes. These are commercially known as Donepezil, Rivastigmine, and Galantamine.
Treatments for Behavior Changes: Since in early-onset dementia the behavioral issues are usually irritability, anxiety, and depression, they prepare the patient for change, and try to keep things as simple as possible when communicating. Medications can be taken to reduce anxiety symptoms, depression, and even antipsychotic symptoms or psychotic episodes.
Therapy to help promote physical and emotional comfort is also important, as well as caregivers need to have certain coping strategies. Here are some aspects to consider when dealing with someone with early onset dementia:
- Avoid being confrontational
- Redirect the person’s attention when needed
- Monitor personal comfort (ask if there is pain, hunger, thirst, etc.)
- Create a calm environment
- Provide a security object
- Look for reasons behind each behavior
- Don’t take the behavior personally
Treatments for Sleep changes: People with early onset dementia tend to change sleeping patterns due to the brain changes. Even though these are more common in later stages, it’s important to keep an eye out for these two symptoms:
- Difficulty sleeping
- Daytime napping and other moments of sleep-wake cycle
To prevent these sleep changes follow these tips:
- Keep regular times for meals and going to bed
- Seek sunlight exposure
- Encourage day exercise
- Avoid stimulants (coffee, nicotine, alcohol)
- Avoid taking the cholinesterase inhibitor at night
- Provide nightlights
- Use the bed ONLY for sleep
- Don’t watch TV before bed
A film, Still Alice talks precisely about early onset dementia: specifically early onset Alzheimer’s. In the movie, we can see Alice’s life, a successful professor of cognitive psychology, specialized in linguistics, who was diagnosed with Early Onset Dementia Alzheimer at 50.
Early Onset Dementia Prevention and Risk Factors
There are some risk factors that we cannot avoid, such as genetics and age. However, researchers have focused on other aspects to reduce risk and prevent early onset dementia.
One of the main areas they found related to this is cardiovascular risk factors. Anything that damages your blood vessels is a risk to the blood flow in your brain, therefore a risk to brain health. Blood vessel changes in the brain lead to vascular, however, it is always important to reduce blood pressure, cholesterol and blood sugar so you don’t put your brain in danger.
Physical exercise is also important to reduce risk of early onset dementia because the brain cells can benefit from the extra oxygen flow.
Many researchers have said that even diet might reduce your risk of having early onset dementia. Recently, studies have shown that having a healthy heart diet influences the brain positively, reducing the risks of suffering from any type of dementia.
We hope you enjoyed this article and please remember that if you have a family member you fear might have early onset dementia, go immediately to your primary physician. Feel free to leave a comment below!
Alejandra is a clinical and health psychologist. She is a child specialist with a diploma in evaluation and intervention in autism. She has worked in different schools with young children and private practice for over 6 years. She is interested in early childhood intervention, emotional intelligence, and attachment styles. As a brain and human behavior enthusiast, she is more than happy to answer your questions and share her experience.
