Dealing with early-onset Alzheimer’s

September 21, across the globe, marks World Alzheimer’s Day. And contrary to popular belief, this disease — a form of progressive, memory-robbing brain condition — can often show up in your 20s or 30s, owing to genetic mutations and other factors.

“Alzheimer’s disease is a brain disorder causing people to slowly and permanently lose their memory and other cognitive functions, and is named after German psychiatrist and pathologist Alois Alzheimer, who first described the disease in 1906,” tells Dr. Pankaj Agarwal, Senior Consultant, Neurology, Global Hospital, Mumbai.

Amyloid plaques buildup is a hallmark of Alzheimer’s, which is commonly found in those who have the disease. “It is because of degeneration of brain cells involved with memory and accumulation of abnormal proteins and plaques in the brain. Though it’s a disease of an ageing population, 10% of cases are detected at a young age. Family history, genetic mutations and exposure to toxic chemicals may be responsible for early age onset,” says Dr Amruta Bakshi, MBBS, MD(Biochemistry) Family Physician, Loop Health.

The signs of early-onset Alzheimer’s are largely the same as those for the late-onset version of the disease. It starts with small memory lapses and problems with the brain function that get worse until they affect the patient’s ability to manage daily life.

“The first problem to occur is impaired short term memory. The patient may start asking repeatedly for tea, even after he has had it once. He/she may forget to do things that he has been asked to do in the morning such as deposit money in a bank,” says Dr Siddharth Kharkar, Senior Consultant, Neurologist, Nanavati Max Hospital. In addition to these symptoms, such patients may find it difficult to find the right word initially and complete sentences. In some patients, their behavior and judgement may become impaired.

Most people with young-onset Alzheimer’s have the most common form of the disease, called sporadic Alzheimer’s. “This type isn’t caused by genetics, and experts are yet to find out why these people get the disease at a younger age than others do.But others with young-onset Alzheimer’s have a type of the disease called familial Alzheimer’s disease. They’re likely to have a parent or grandparent who also developed Alzheimer’s at a younger age,” explains Dr. Shuchin Bajaj, Founder Director, Ujala Cygnus Group of Hospitals.

Some would ask but what is childhood alzheimer’s then? Childhood Alzheimer’s can be referred to -- Niemann-Pick disease type C (NPC) and Sanfilippo syndrome or mucopolysaccharidosis type III (MPS III). Both diseases are what’s known as lysosomal storage disorders. “When a child has one of these genetic diseases the lysosomes of their cells don’t function properly. The lysosomes of cells help process sugar and cholesterol so the body can use them. When lysosomes aren’t working properly, these nutrients buildup inside cells instead. This causes cells to malfunction and eventually die off. In the case of NPC and MPS III, this cell death affects memory and other brain functions.Over time, this interferes with connections in the brain and leads to memory and other problems,” says Dr Rajnish Kumar, HOD- Neurology, Paras Hospitals, Gurgaon.

Dr Prashant Makhija, Consultant Neurologist, Wockhardt Hospital, Mumbai Central relays a patient’s journey. “One of our patients started showing forgetfulness in her early 60s which was initially ignored by the family members as simply age related but they felt a bit suspicious when the patient started making frequent mistakes in money matters which she was handling with ease earlier. Once she lost her way from office and family members lodged a police complaint and eventually they were able to track her the next day, it is then the family members realized and brought her for an evaluation.”

An accurate diagnosis of young-onset Alzheimer’s is crucial for medical reasons to rule out other potential issues “Early screening and detection among younger people through blood tests to study fat in the bloodstream, defective IRS-1 protein and blood marker microRNA, could lead the way in slowing down the progression of the disease, and improved and effective prevention and treatment modalities,” says Dr. Angeli Misra, Consultant Pathologist and Founder, Lifeline Laboratory.

Things to keep in mind

Doing things that are meaningful and enjoyable are important for the overall well-being of a person with Alzheimer’s disease. Activities such as listening to music or dancing, reading or listening to books, gardening and crafts can support such patients.

While Alzheimers still has no definitive cure in medicines, however, “A combination of diet, food supplements and nutraceuticals have shown a new pathway to repair the condition naturally. Food with antioxidants, vitamin D, Zinc, healthy fats like Omega 3 along with a combination of nutraceuticals like Ginseng, Ginkgo Biloba, MCT(Medium Chain Triglycerides) and turmeric could help in treating Alzheimer’s,” says Kamayani Naresh, Founder of Zyropathy.

Humour is a great way to release stress and tension. It helps in coping with difficult emotions that come up when caring for someone with this condition. “A lady was checking out her mother’s memory by asking her what she had for lunch one day. Her mother, who had Alzheimer’s, had of course forgotten but pat came the reply “something hot”. No one could dispute that, and all in the family ended up laughing,” says Dr. (Lt Gen) CS Narayanan, VSM, HOD And Consultant, Department Of Neurology HCMCT Manipal Hospitals, Dwarka New Delhi

Regular exercise is an important part of a treatment plan. Activities such as a daily walk can help improve mood and maintain the health of joints, muscles and the heart.