In 2015, actress Julianne Moore won an Academy Award for her portrayal of a woman diagnosed with early-onset Alzheimer’s disease in the critically acclaimed movie “Still Alice.” As I watched the movie, I was not only captivated with Moore’s performance but the fact that her character was only 50 years old when she was inflicted with such a debilitating disease.
Being on the cusp of this age myself, I was intrigued about this important — yet rather unknown — issue facing aging adults today. Alzheimer’s disease does not only affect senior citizens. Men and women as young as 30-somethings can show some of the symptoms of this memory impairment, yet most are in their 40s and 50s.
With the senior population expected to reach more than 83 million by 2050, the number of cases of early-onset Alzheimer’s disease will more than likely increase. This will not only put a strain on a healthcare system that is already in need of geriatric doctors but also elder care facilities for those who can’t or prefer not to age in place.
The overall population identified as having Alzheimer’s disease will increase due to the “graying population,” said Dr. Jessica Zwerling, director of the Memory Disorders Center and associate director of the Montefiore Einstein Center for the Aging Brain. “We are at the beginning of a coming crisis of Alzheimer’s disease. As primary care physicians gain skills in the recognition of this disease at its early phase, the number of cases identified will increase.”
Roughly 5% of the more than 5 million people with Alzheimer’s in the United States have been diagnosed with the early-onset type. Symptoms usually start with losing simple, everyday objects, including eyeglasses, car keys and cell phones.
About Early-Onset Alzheimer’s Disease
The symptoms for early- and older-onset Alzheimer’s disease are about the same, including gradual memory loss and cognitive difficulties. However, most doctors don’t understand why this disease can strike a younger adult. There has been research conducted that shows several rare genes that directly cause Alzheimer’s. Men and women who inherit these genes tend to develop the disease younger than 65 years old. At this point, it is commonly referred to as familial Alzheimer’s disease.
This type of dementia is typically hereditary, meaning one of your parents had it and your siblings and children have a 50 percent chance of inheriting it. There are three known genes that cause this type of Alzheimer’s disease: amyloid precursor protein (APP), presenilin-1 (PS1) and presenilin-2 (PS2). Of these three, PS1 accounts for most of the early-onset Alzheimer’s cases, while the other two are more rare. A pathogenic mutation in any of these three genes pretty much guarantees you will develop the disease.
“Using autosomal-dominant Alzheimer’s disease families, studies can examine biomarker levels, including the preclinical Alzheimer’s disease interval, many years prior to dementia onset,” said Dr. Zwerling. “Studies of families with positive genetics are important, as we can study the preclinical and early stages of dementia when patients are asymptomatic. Although there are differences between ‘sporadic’ Alzheimer’s, the study of a genetic population is helpful for future primary prevention treatments.”
The Demands of Senior Care
There is a growing movement to bring back aging in place instead of transferring a loved one with Alzheimer’s disease to an elder care facility. The same is even more true for those with the early-onset diagnosis. Many of today’s senior facilities that are equipped with memory care units are filled with residents over the age of 65. While younger adults are accepted in most of them, it’s unclear whether they will feel comfortable being there because of their younger age or will embrace the great amenities for younger seniors.
“Regardless of age of diagnosis, the behavioral symptoms are the same,” Zwerling said. “I think by educating families and helping them navigate the health system and knocking down the walls between hospitals, community-based organizations and local practices to ensure proper transitions between long-term care facilities, home, and hospitals, etc., we can help patients afflicted with Alzheimer’s disease to age in place. If we reduce segmented care, we can better serve this population.”
Early diagnosis of Alzheimer’s is the key to alleviating the hardships caused by disease. This allows time for patients and families to arrange for care and start discussing safety and any other concerns that may arise.