Memory loss may not
always be first sign of Alzheimer’s
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[May 22, 2015]
By Lisa Rapaport
(Reuters Health) - While memory loss is
thought to be a classical first sign of Alzheimer’s disease, some
middle-aged people and younger seniors may initially experience
different cognitive problems such as trouble with language or problem
solving, a large U.S. study suggests.
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Researchers reviewed data on early symptoms for almost 8,000
Alzheimer’s patients and found one in four people under age 60 had a
chief complaint unrelated to memory, though memory was by far still
the most common problem overall.
“Non-memory first cognitive symptoms were more common in younger
Alzheimer’s disease patients,” lead study author Josephine Barnes, a
researcher at the National Hospital for Neurology and Neurosurgery
in London, said by email. “Tests which explore and investigate these
non-memory cognitive problems should be used so that non-memory
deficits are not overlooked.”
Alzheimer’s is a brain disorder than gradually destroys memory and
thinking skills and eventually leaves people unable to carry out
simple tasks like dressing or eating. The disease is the most common
cause of dementia among older adults, and afflicts more than 5
million Americans, according to the National Institutes of Health.
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Inside the brain, Alzheimer’s is associated with abnormal clumps
known as amyloid plaques and tangled bundles of fibers, often called
tau or tangles. Scientists suspect that the damage begins in the
hippocampus, a region of the brain involved in memory.
Barnes and colleagues reviewed neurological test results from a
large U.S. database of Alzheimer’s patients to see whether the early
symptoms people reported differed by age.
On average, patients were 75 years old when they first sought
treatment for Alzheimer’s, though they ranged in age from 36 to 110.
Most of them had mild to moderate dementia.
Among the patients who reported cognitive difficulties as their
first symptoms, the proportion citing something other than memory
shrank with increasing age. One in five patients in their 60s cited
difficulties unrelated to memory, but this dropped to one in 10 for
people in their 70s.
Because Alzheimer’s can only be definitively diagnosed after death
by looking for tangles and plaque on the brain during an autopsy,
this study like others exploring the disease runs the risk of
including at least some patients who don’t actually have the
condition, the authors acknowledge in the journal Alzheimer’s and
Dementia.
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In addition, it’s possible that because the study drew patients from
academic medical centers, it lured more complex cases and might not
be representative of a typical Alzheimer’s patient, the authors
note.
Understanding how Alzheimer’s symptoms might surface in younger
patients is crucial for diagnosing them sooner and starting
treatment at a point when it can do the most good, said Dr. Andrew
Budson, chief of cognitive and behavioral neurology at the VA Boston
Healthcare System and a neurology professor at Boston University.
The best available medicine for the disease can only turn back the
clock, reversing symptoms enough to give patients the same abilities
they had up to a year earlier, Budson said.
“You can’t slow the clock down, you can just reset it,” Budson said.
“It is much better to dial it back to repeat a year in your 60s than
in your 80s.”
SOURCE: http://bit.ly/1INu4Y1 Alzheimer’s and Dementia, online April
24, 2015.
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