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What is Early Onset Dementia and How Can We Reduce Our Risk for It?

Dementia symptoms like memory and/or emotional disturbances, agitation and decreased cognitive functioning, most commonly exhibited in those diagnosed with Alzheimer’s, are not exclusive to the golden years. 1 Early or young onset dementia is diagnosed when a person is 65 or younger experiences memory loss and other cognitive difficulties associated with Alzheimer’s disease. Early onset dementia—which can occur in a person’s 40s and 50s—is believed to occur in up to 5 percent of the 5 million Americans currently living with Alzheimer’s. 2 Experts have yet to pinpoint the reason younger adults experience early onset dementia. However, they have narrowed down a few possible causes. “We can see dementia following a head injury,” says James Giordano, Ph.D. professor, of Neurology and Biochemistry and Chief, Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics at Georgetown University Medical Center. Chronic traumatic encephalopathy (CTE) the degenerative brain disease often occurring in those with a history of repetitive brain injuries (football players, boxers, military veterans, etc.) can cause dementia-like symptoms in those much younger than 65. 1 “Early onset dementia can also occur in an individual with vascular problems. The same inflammatory causes of clogging or hardening of the arteries can negatively affect the brain.” But Giordano says your DNA is likely the biggest culprit and contributor to a diagnosis of early-onset dementia. “There is a very strong genetic component to early onset dementia,” he explains. “A few genes that directly cause Alzheimer’s disease have been identified and those who inherit them from their parents can develop symptoms as early as in their 30s.” This is called familial early onset dementia. Inflammation May Also be to Blame Early onset dementia can occur in those without a family history and genetic risk of the condition. In those instances, Giordano says inflammation is believed to be what triggers changes in the brain resulting in the diagnosis of early onset dementia. “A high level of inflammation in the body can cause diabetes and/or heart disease, among other things,” he explains. “That same type of inflammation is now believed to induce actions in the brain that lead to dementia symptoms.” Exposure to toxins like aluminum and lead has also been examined as a possible—albeit less likely—risk of triggering the inflammatory state that leads to dementia-inducing changes in the brain. 1Your Scale’s Influence on your Brain A new study with 1.3 million participants in the U.S. and Europe published in the Alzheimer's & Dementia journal says those with a high body mass index (BMI) are more likely to develop dementia than those with a normal weight. 2 "The BMI-dementia association observed in longitudinal population studies, such as ours, is actually attributable to two processes," said lead author of the study, Professor Mika Kivimäki (UCL Institute of Epidemiology & Health). "One is an adverse effect of excess body fat on dementia risk. The other is weight loss due to preclinical dementia. For this reason, people who develop dementia may have a higher-than-average body mass index some 20 years before dementia onset, but close to overt dementia have a lower BMI than those who remain healthy. The new study confirms both the adverse effect of obesity as well as weight loss caused by metabolic changes during the pre-dementia stage." 2 Giordano says he’s not surprised by the new study’s findings. If your scales readout is inching upward due to visceral, or belly, fat, Giordano says you could have an even higher risk for early onset dementia than those who carry excess weight all over their body. “Apple shapes can be a bit more dangerous because that visceral fat is white fat, which triggers a cascade of chemicals in the body that can increase glucose sensitivity and ultimately inflammation.” Diagnosing Early Onset Dementia Giordano says regardless of a person’s age, early diagnosis of any cognitive changes is important to finding the most appropriate intervene that may help slow the progression of the disease. 1 “You can’t reverse memory loss or other neurological changes, but you may be able to slow down any new loss or changes.” He says diagnosing early onset dementia can be tricky because many patients—or their loved ones—may justify symptoms like memory loss to stress and/or a hectic lifestyle. “As a result, they don’t speak to their doctor to have a diagnostic evaluation that may lead to interventions.” Evaluation of the diagnosis includes pencil and paper tests administered by a clinician. The results may indicate loss of cognitive function at an early stage. 1 “Blood tests to detect the presence of inflammatory markers and also tests that determine if the person has a strong genetic risk of early onset dementia and an MRI screening are also commonly used to diagnose the condition,” says Giordano. Reducing your Risk “A healthy lifestyle that includes a well-balanced diet and daily exercise promotes a healthy weight that then counters a body’s inflammatory response and reduce the risk of non-familial, early onset dementia,” he explains. So your brain is less likely to be subjected to negative changes that occur when the body is battling inflammation. “It’s never too late to take healthy steps that work toward preventing dementia symptoms,” Giordano stress. Sources:
  1. Interview with James Giordano.
  2. https://www.sciencedaily.com/releases/2017/11/171130133812.htm
  3. https://www.alz.org/alzheimers_disease_early_onset.asp
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About the Author(s)

For over two decades, Gina Roberts-Grey has pored over studies and interviewed leading health experts on topics ranging from healthy aging, caregiving and longevity. Having been an active caregiver to her grandparents who lived into their 90’s, Gina is passionate about supporting caregivers through their journeys. Her work has been featured in publications like Woman’s Day, AARP, Oprah, Neurology Now and many more.

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