General Practice 2022

Early Alzheimer's: what é, symptoms, causes and treatment

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Early Alzheimer's: what é, symptoms, causes and treatment
Early Alzheimer's: what é, symptoms, causes and treatment

Early Alzheimer's, or "Presenile Dementia", is a rare type of Alzheimer's that begins before age 65, usually between 40 and 50, and is related to hereditary genetic alterations that lead to progressive loss of cognition, resulting in symptoms such as memory failure or loss, mental confusion, aggression, and difficulty performing daily routine activities.

These genetic alterations lead to the accumulation of "tau" and beta-amyloid proteins in the brain, specifically in the part responsible for speech and memory, resulting in the development of Alzheimer's symptoms. Know how to recognize the symptoms of Alzheimer's.

When the first symptoms appear, they are often confused with excess stress or depression, and therefore the diagnosis of early Alzheimer's ends up being late.The ideal is to consult a neurologist whenever symptoms appear and there is a family history of the disease, as early diagnosis is important to start treatment and delay the worsening of Alzheimer's.

Main symptoms

Symptoms of early Alzheimer's generally develop faster than Alzheimer's at an older age, causing a rapid loss of cognition.

The main symptoms of early Alzheimer's are:

  • Vision changes, such as difficulty seeing a full picture;
  • Difficulty perceiving depth;
  • Difficulty recognizing faces and people;
  • Decreased ability to communicate verbal or written;
  • Learning difficulties of new tasks;
  • Forgetting common things, such as whether you had lunch or not;
  • Frequent memory failures, such as leaving home and forgetting the way to go;
  • Confusion, such as not knowing where you are or what you were doing there;
  • Store objects in inappropriate places, such as the phone inside the refrigerator;
  • Staying silent for long periods in the middle of a conversation;
  • Insomnia, difficulty sleeping or multiple nighttime awakenings;
  • Difficulty doing simple math, such as 3 x 4, or thinking logically;
  • Loss of movement, such as difficulty getting up on your own;
  • Anguish and depression, like sadness that does not go away and the desire to isolate yourself;
  • Hypersexuality, public masturbation or inappropriate speech may occur;
  • Excessive irritability for not remembering certain things or not understanding a certain situation;
  • Aggressiveness, such as hitting family and friends, throwing things against a wall or floor;
  • Apathy, as if nothing else matters.

In the case of early Alzheimer's, the symptoms of the disease set in much faster than in the elderly and the inability to take care of oneself appears very early. Know how to recognize the symptoms of Alzheimer's in the elderly.

It is important to consult a neurologist as soon as symptoms indicative of early Alzheimer's appear, so that a diagnosis can be made and appropriate treatment initiated. This consultation is even more important in the case of people who have Alzheimer's in the family, as they have a higher risk of developing early Alzheimer's.

Alzheimer's Online Test

Take this quick test to find out if there is a risk of having Alzheimer's:

Evaluate your risk of developing Alzheimer's

Illustrative image of the questionnaire
  • I have a good memory, although there are small forgettings that do not interfere with my day-to-day.
  • Sometimes I forget things like the question I was asked, I forget appointments or where I left my keys.
  • I often forget what I was doing in the kitchen, living room, or bedroom and also what I was doing.
  • I can't remember simple, recent information like the name of someone I just met, even if I try very hard.
  • It's impossible to remember where I am and who the people around me are.
  • Yes! I also find it easy to recognize people and places.
  • I don't remember very well what day it is and I have a slight difficulty saving dates.
  • I'm not sure what month it is, but I can recognize familiar locations. However, I get a little confused in new places and can get lost.
  • I don't know. I also don't remember exactly who my family members are, where I live and I don't remember anything about my past.
  • All I know is my name, but sometimes I remember the names of my children, grandchildren or other relatives
  • I am fully capable of solving day-to-day problems and dealing well with personal and financial issues.
  • I have some difficulty understanding some abstract concepts (such as why a person is sad).
  • I'm feeling a little insecure and afraid to make decisions. That's why I prefer that others decide for me.
  • I don't feel capable of solving any problem and the only decision I make is what I want to eat.
  • I am unable to make any decisions and am totally dependent on other people for help.
  • Yes, I can work normally, I shop, I am involved with the community, church and other social groups.
  • Yes, but I'm starting to have some trouble driving. Still, I feel safe and know how to handle emergency or unplanned situations.
  • Yes, but I am unable to be alone in important situations and need someone to accompany me on social engagements.
  • No, I don't leave the house alone because I don't have the capacity and I always need help.
  • No, I am unable to leave the house alone and I am too sick for it.
  • Great. I still have chores around the house, I have hobbies and personal interests.
  • I no longer feel like doing anything indoors, but if you insist, I can try to do something.
  • I completely abandoned my activities, as well as more complex hobbies and interests.
  • All I know is showering alone, getting dressed and watching TV and I am not able to do any other chores around the house.
  • I can't do anything on my own and I need help with everything.
  • I am fully capable of taking care of myself, dressing, washing, showering and using the bathroom.
  • I'm starting to have some trouble taking care of my own personal hygiene.
  • I need others to remind me that I have to go to the bathroom, but I manage to relieve myself.
  • I need help dressing and cleaning and sometimes I pee on my clothes.
  • I can't do anything myself and I need someone else to take care of my personal hygiene.
  • I have normal social behavior and there are no changes in my personality.
  • I have small changes in my behavior, personality and emotional control.
  • My personality is slowly changing, before I was very nice and now I'm a little grumpy.
  • They say I've changed a lot and I'm not the same person anymore and I'm already shunned by my old friends, neighbors and distant relatives.
  • My behavior has changed a lot and I have become a difficult and unpleasant person.
  • I have no difficulty speaking or writing.
  • I'm starting to have some trouble finding the right words and it takes me longer to complete my reasoning.
  • It is getting harder and harder to find the right words and I have been having trouble naming objects and I notice that I have less vocabulary.
  • It's very difficult to communicate, I have difficulty with words, understanding what they say and I don't know how to read or write.
  • I just can't communicate, I don't say much, I don't write and I don't understand very well what they say to me.
  • Normal, I don't notice any change in my mood, interest or motivation.
  • Sometimes I get sad, nervous, anxious or depressed, but I don't have any major worries in life.
  • I get sad, nervous or anxious every day and this has become more and more frequent.
  • Every day I feel sad, nervous, anxious or depressed and have no interest or motivation to do any task.
  • Sadness, depression, anxiety and nervousness are my daily companions and I totally lost my interest in things and I have no motivation for anything anymore.
  • I have perfect attention, good concentration and great interaction with everything around me.
  • I'm starting to have trouble paying attention to something and get sleepy during the day.
  • I have some attention difficulties and poor concentration, so I can stare at a point or with my eyes closed for some time, even without sleeping.
  • I spend most of the day sleeping, I don't pay attention to anything and when I talk I say things that are illogical or that have no relation to the topic of conversation.
  • I can't pay attention to anything and I'm completely unfocused.

At what age does early Alzheimer's appear?

Usually, early Alzheimer's appears between 40 and 50 years old, however there is no exact age for it to start, as there are reports of onset at both 27 and 51 years old. The most important thing is that people who have a family history of Alzheimer's are aware of the appearance of symptoms.

How to confirm the diagnosis

The diagnosis of early Alzheimer's is made by the neurologist by evaluating the symptoms and family history of Alzheimer's, memory and cognition tests, and through imaging tests, such as MRI or CT scan of the brain.

In addition, the doctor may order clinical tests to rule out other diseases that cause memory changes, such as hypothyroidism, depression, vitamin B12 deficiency, hepatitis or HIV, for example.

Possible causes

The exact cause of early Alzheimer's is not fully known, but it is believed to occur due to mutations in the APP, PSEN1 and PSEN2 genes, which lead to the accumulation of proteins in the brain, such as beta-amyloid and Tau protein. This accumulation of proteins seems to cause inflammation, disorganization and destruction of neuronal cells, mainly in the areas responsible for memory and interpretation of information.

These genetic changes are hereditary, which means that early Alzheimer's is more common to run within the same family, as the mutations can be passed from parents to children.

How the treatment is done

The treatment of early Alzheimer's should be guided by the neurologist, to help reduce symptoms and delay the progression of the disease.In this way, the doctor can prescribe different drugs, such as donepezil, rivastigmine, galantamine or memantine, which help maintain mental cognitive functions. See all Alzheimer's drug options.

In addition, the doctor may also recommend the use of medication to improve sleep quality and mood, as well as psychotherapy, regular physical activity and a balanced diet, including antioxidant foods.

The treatment of early Alzheimer's must be done by a multidisciplinary team, with doctors, physical therapist, speech therapist, nutritionist and occupational therapist, so that it is possible to avoid the appearance of other symptoms and complications, and improve the quality of life.

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