By Dr. Alvin Chang, Guest columnist
Alzheimer’s disease is often associated with older adults, typically those over 65 years old. But for some, the journey begins much earlier — often in their 50s — when they are still in the prime years of their careers and family lives.
This form of Alzheimer’s, known as early-onset Alzheimer’s, is often more difficult to diagnose and manage due to the relatively young age of the individuals affected. As a geriatric doctor, I’ve seen firsthand how challenging this diagnosis can be, not just for the individual but for their families as well. But with early detection, lifestyle changes and proper management, we can help patients and their families navigate this difficult journey with dignity and understanding.
Alzheimer’s disease is a progressive neurodegenerative condition that affects cognitive abilities like memory, reasoning and problem-solving. It gradually erodes a person’s ability to carry out everyday tasks, including managing finances, maintaining relationships, and taking care of themselves. Early-onset Alzheimer’s refers to when symptoms appear in individuals under 65, with some people being diagnosed as young as 50.
Though the symptoms are similar to those in later-onset Alzheimer’s, the impact on younger individuals can be far more disruptive to their work, relationships and long-term planning.
One of the challenges with early-onset Alzheimer’s is that many individuals are still active in their careers, raising young families and maintaining social lives. The early signs of the disease are often subtle and can easily be attributed to stress, aging or work-related pressures.
But it’s not just about managing personal responsibilities. Many of these individuals are also part of the “sandwich generation,” balancing the care of their aging parents. As the disease progresses, it becomes increasingly difficult to juggle these dual caregiving roles, often leading to emotional, physical and financial strain. This makes it even more critical to recognize the early signs of Alzheimer’s and seek medical advice.
Early intervention can help manage symptoms, but it also opens the door to essential planning, including financial strategies, legal preparations and support for caregivers. With the right resources in place, individuals can better navigate the complexities of living with Alzheimer’s while continuing to care for both their families and aging parents.
When it comes to Alzheimer’s, early detection is key. Early-onset Alzheimer’s can be difficult to identify because it doesn’t necessarily fit the common stereotypes people have about Alzheimer’s, such as severe memory loss in elderly individuals. Below are some of the signs that I advise patients and families to look for:
- Memory loss: While everyone forgets things occasionally, individuals with early-onset Alzheimer’s will begin to experience significant memory lapses that interfere with daily life. They may forget recent conversations, appointments or where they’ve placed items that they use every day. Over time, the forgetfulness becomes more pronounced and noticeable to family members.
- Difficulty with problem-solving and planning: People with Alzheimer’s may have trouble managing tasks that once seemed routine, like budgeting, following a recipe or even keeping track of appointments. Tasks that require multiple steps, such as planning a vacation or making decisions about daily schedules, can become overwhelming. This may be one of the earliest and most troubling signs, as it can directly impact a person’s ability to work or take care of their family.
- Language and communication issues: As the disease progresses, individuals may have difficulty finding the right words during conversations. They may forget common words, repeat themselves often, or struggle to follow the flow of a conversation. This can be frustrating for both the person with Alzheimer’s and their loved ones, as it can lead to feelings of isolation and embarrassment.
- Disorientation and confusion: A person with early-onset Alzheimer’s may become confused about the time of day, the season or even their location. They might forget how they got somewhere or what they were supposed to be doing. This confusion can be disorienting and frightening, not only for the person but also for their caregivers.
- Mood and personality changes: It’s common for individuals with Alzheimer’s to experience changes in mood and behavior. They might become unusually anxious, irritable or depressed. In some cases, they may withdraw from social activities or exhibit signs of apathy. The person may no longer seem like the same individual, and family members often find these personality changes especially difficult to handle.
- Withdrawal from social activities: As memory, communication, and problem-solving abilities decline, many people with Alzheimer’s begin to withdraw from social interactions. They may stop participating in activities they once loved, like going to the movies, socializing with friends, or even attending family gatherings. This withdrawal can worsen feelings of isolation, both for the individual and their family.
While the exact cause of Alzheimer’s is not fully understood, several risk factors can increase the likelihood of developing early-onset Alzheimer’s after the age of 50. Genetics plays a significant role, with mutations in the APOE, PSEN1, PSEN2 and APP genes, along with a family history of Alzheimer’s, being strong indicators. Individuals over 50 who have had head injuries, such as multiple concussions, may be at a higher risk due to cumulative brain damage that accelerates cognitive decline.
As we age, chronic health conditions like diabetes, high blood pressure and cardiovascular disease become more prevalent. These conditions can negatively impact brain health, increasing vulnerability to Alzheimer’s and other forms of dementia. A growing body of research has also highlighted the link between hearing loss and Alzheimer’s risk. Untreated hearing impairment can lead to cognitive overload, social isolation and even brain atrophy, all of which heighten the likelihood of developing Alzheimer’s, especially in those over 50.
For individuals with Down syndrome, the risk is even higher, as the extra copy of chromosome 21, which contains the APP gene, predisposes them to earlier onset of Alzheimer’s. Additionally, lifestyle factors — like a poor diet, lack of exercise, smoking and chronic stress — can accelerate brain aging.
For individuals over 50, making lifestyle changes is crucial for managing Alzheimer’s symptoms and slowing progression. Healthy habits not only improve brain function but also support overall well-being. Here are some key areas to focus on:
- Regular physical activity: Exercise increases blood flow to the brain, supports new neuron growth, and reduces inflammation. Activities like walking, swimming, or tai chi, along with light strength training, can improve both brain function and quality of life. Aim for at least 30 minutes of moderate exercise most days.
- Brain-healthy diet: A Mediterranean-style diet, rich in fruits, vegetables, whole grains, lean proteins (like fish), and healthy fats, supports cognitive function. Omega-3 fatty acids found in fatty fish and nuts are especially beneficial, while minimizing processed foods and sugar helps reduce brain inflammation.
- Mental stimulation: Keeping the brain engaged with activities like puzzles, reading, or learning new skills strengthens cognitive reserve. Social interaction, such as joining a book club or volunteering, also helps reduce the risk of cognitive decline.
- Quality sleep: Aim for 7-9 hours of sleep each night. Poor sleep is linked to the buildup of beta-amyloid plaques, which are associated with Alzheimer’s. Establishing a calming sleep routine and addressing sleep disorders like sleep apnea is important for brain health.
- Social engagement: Staying socially active can protect brain health by reducing isolation and providing emotional support. Regular social interactions boost cognitive function and help manage stress.
- Stress management: Chronic stress increases cortisol levels, which can damage brain cells. Techniques like mindfulness meditation, yoga, and deep breathing exercises help lower cortisol, improve mood, and enhance cognitive clarity. Physical activity also helps manage stress by releasing “feel-good” endorphins.
- Medications: Medications like Donepezil (Aricept) and Memantine (Namenda) can help manage symptoms of memory loss, confusion, and mood changes. These medications do not cure Alzheimer’s, but they can offer relief and improve quality of life.
- Support for caregivers: Caring for someone with early-onset Alzheimer’s can be physically and emotionally draining. I encourage family members to seek caregiver support and respite care. Support groups can provide both emotional support and practical advice for managing the challenges of caregiving.
By focusing on these lifestyle changes, individuals over 50 can create a proactive approach to managing your brain health and reducing the risk of Alzheimer’s. Not only can these changes help slow the progression of cognitive decline, but they can also improve overall quality of life, enhance mental well-being, and provide a sense of empowerment as you age.
Dr. Alvin Chang specializes in internal medicine, geriatric medicine, and undersea and hyperbaric medicine. He practices at Access Community Health Center in Santa Ana as part of MemorialCare Independent Physicians. He provides comprehensive care to older adults, addressing chronic conditions, cognitive health and the unique challenges of aging.