Number of Alzheimer's patients in their 40s or 50s may be underestimated

Written by Paul Brandas

Is it possible to develop this disease at such a young age?Your family history may speak to that, medical experts say.

Last week, I watched a movie called “Still Alice” starring Julianne Moore. It was disturbing and heartbreaking to watch.

Based on a true story, Moore (who won an Academy Award for his performance) plays a razor-sharp character who, at the age of 50, begins to get confused about things, such as getting lost on campus, fumbling for words, and introducing himself. He plays a professor at Columbia University. He talks about himself to the people he introduced himself to 10 minutes ago, etc.

Concerned, she consults a neurologist who discovers that Alice has a rare early form of Alzheimer's disease, which is genetic, meaning her children are also susceptible to it. The words were announced like a bolt of lightning.

Alzheimer's disease? 50 years old? Is this common? Probably more common than you think. Audrey Duarte, a professor of neurology at the University of Texas at Austin, said the character Alice develops “a variant of Alzheimer's disease called early-onset Alzheimer's disease (EOAD), which is diagnosed in people under 65 years of age,” and that “there is no explanation for the cause.” I can do it,” he said. Probably he represents 5% to 10% of all Alzheimer's disease cases. ”

However, she emphasizes that the common perception about Alzheimer's disease remains true. “Most people who are diagnosed are in their late 70s or older,” she said.

Is it possible to develop this terrible disease at such a young age? Dr. Duarte says family history may be telling, as “there appears to be a stronger genetic basis than in later cases.” In her film, Alice is devastated by her own diagnosis and apologetically tells her children that they are at high risk for the disease.

Here's what we know and what we don't know. According to the Mayo Clinic, “Most people with Alzheimer's disease are over 65 years old.” “Approximately 1 in 9 people over the age of 65 in the United States has Alzheimer's disease. Approximately 110 out of 100,000 adults between the ages of 30 and 64 have early-onset Alzheimer's disease. Early-onset Alzheimer's disease For most people, the cause is not related to Is not … ”

sleep quality

Meanwhile, for the majority of people who develop Alzheimer's disease later in life (90% to 95% of cases), new research may point to a link between Alzheimer's disease and sleep quantity and quality.

“Compelling data from human studies show that poor sleep quality, including restless and fragmented sleep in older adults, predicts an increased risk of developing Alzheimer's disease years later. '' Duarte said.

She also points to studies on rodents and, more recently, humans, showing that “a single night of sleep deprivation causes an increase in the amount of beta-amyloid in the brain, which is associated with ''So, although there is still much to study, these results suggest that good sleep is a potential protective factor against Alzheimer's disease. ”

Does that mean I need to spend more time working? necessarily. Some people need more, while others can function well with less. “And to make things even more complicated,” Duarte added, “that number of hours can change over time and as your health progresses. All we can say is: On average, they sleep for very little time.” [less than 5 hours per night] and a very long sleep [more than 9 hours] In adults, it is associated with poorer health and decreased cognitive function. Sleep quality is also important. Consistent sleep without frequently waking up or moving your body will also lead to better results. ”

Read: People in these jobs are 40% less likely to develop cognitive impairment after age 70

One of the problems with Alzheimer's disease research is the relative lack of data. We know the big picture. According to estimates by the Alzheimer's Association, approximately 7 million Americans are currently living with the disease, and that number will nearly double to 13 million by 2050. We know that Alzheimer's disease is the fifth leading cause of death for Americans over the age of 65. older. We know that medical costs related to Alzheimer's disease could reach $360 billion this year and could soar to nearly $1 trillion by 2050.

Despite this, Terry Moffitt, a professor of psychology and neuroscience at Duke University, says, “The United States does not maintain a national health registry of diagnoses. This is true even in countries that keep them.” , Norway, and Sweden, these registries are seriously undercounted. ”

Why this? Medical experts say Alzheimer's disease has no cure. (However, there are some treatments that can help temporarily slow the progression of the disease.)

She added that it's certainly possible, if unlikely, that the true number of Americans living with this terrible disease is also being underestimated.

“More than 20% of older Americans live in situations where no one in their household is aware of their symptoms,” she says. “They live alone, they live in rural areas, or their children live in other parts of the country. I don't like taking them to the doctor because it upsets them.

hesitant to seek medical help

An interesting observation, perhaps those in more privileged circumstances may avoid going to the doctor for similar reasons. Regardless of race or economic status, no one wants to hear that they or a loved one has this terrible disease. So we didn't want to touch on this third rail type of issue and tiptoed around it. In Still Alice, Alice's family seemed to be in denial until her actions and her accelerating decline became impossible to ignore.

Because of this, Moffitt suggests that the true age at which someone can actually develop Alzheimer's disease (or its close relative, dementia) may actually be much lower than we think. It is suggested that there is no such thing.

Sometimes she says to me: “The main reason for a dementia evaluation and diagnosis is that an adult child wants to make changes in their parent's life and often needs a record of the diagnosis,” she says. “Getting your parent to stop driving, taking over financial power of attorney, moving your parent into a nursing home,'' etc.

“At that point, their dementia is usually quite advanced,” she added. “And those parents are in their 80s. So we see that the oft-heard observation that the median age of onset of dementia is 80 years can be delayed by 10 to 20 years. In any case. Dementia is a long-term, gradual process, not a sudden onset where you feel well one day and then feel unwell the next.”

10 or 20 years? So is it possible that the median age for Alzheimer's disease is actually much lower than the common perception that it is a disease of the elderly? That's a surprising question that must be answered.

-Paul Brandas

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04/24/24 1133ET

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