What Is Early-Onset Alzheimer’s?

Alzheimer’s disease develops when neurons (nerve cells) in the brain stop functioning, lose connections with other neurons, and eventually die.

Early-onset (also called younger-onset) Alzheimer’s and late-onset Alzheimer’s disease usually affect the brain in similar ways, but the issues each raises for the person who has it — from getting an accurate diagnosis to planning for the future — can be very different.

For most people, the symptoms of early-onset Alzheimer’s mirror those of the late-onset kind, with memory loss usually the first sign of a problem.

• Forgetting important information
• Asking repeatedly for the same information
• Trouble following basic instructions or tasks
• Forgetting the date or season
• Forgetting where you are, or how you got there
• Vision problems, such as depth perception
• Difficulty following conversations or finding words
• Withdrawing at work or in social situations
• Changes in mood or personality
• Poor judgment or uninhibited behavior

• Severe memory loss
• Deep confusion about where you are or life events
• Difficulty with talking, walking, or swallowing
• Having suspicions about family, friends, or caregivers
• Severe mood swings or changes in behavior

For most people with early-onset or late-onset Alzheimer’s, the disease appears to be caused by a combination of genetics, lifestyle, and environmental influences interacting in ways that are still not clearly understood.

Researchers have made progress in identifying genes, passed on in families, that raise the risk of both early-onset and late-onset Alzheimer’s.

A variant of a gene called apolipoprotein E (APOE) increases the odds of developing Alzheimer’s in people of all ages, though it does not mean someone will definitely get the disease. People with two copies of this variant, APOE e4, are even more likely to develop Alzheimer’s (one copy is inherited from each parent).

Studies show that the brains of people with Alzheimer’s — including early-onset Alzheimer’s — contain a large amount of specific proteins in what are known as plaques and tangles.

An early-onset Alzheimer’s diagnosis can be difficult because doctors don’t typically look for the disease in younger people.

To understand what’s causing your symptoms, a doctor should conduct a thorough investigation that includes a detailed family and personal health history, physical and neurological tests, a cognitive assessment, and possibly a brain-imaging scan.

• donepezil (Aricept)
• rivastigmine (Exelon)
• galantamine (Razadyne)
• memantine (Namenda)
• donepezil and memantine (Namzaric)
• lecanemab (Leqembi)
• donanemab (Kisunla)

There’s no cure for Alzheimer’s disease, at any age. But getting a diagnosis as soon as possible may lead to more effective treatment, helping you treat your cognitive symptoms and possibly delaying progression of the disease.

People who develop Alzheimer’s disease in their thirties, forties, or fifties face unique social, emotional, and financial challenges.

• Be open about the changes in your health and life.
• Take steps to address your child’s emotional needs, such as meeting with a counselor who focuses on helping families cope with chronic illness.
• Make sure your child’s teachers and school social workers are aware of what’s happening.
• Stay involved in your child’s life and plan activities you can still do together. If driving is no longer possible for you, explore other ways to get around.
• Humor helps. Find things you can laugh about together.
• Record your thoughts and feelings in a journal or on video or audio for your child to have later in life.

People with early-onset Alzheimer’s disease may face a daunting financial future, particularly if their job is their main source of income.

Those who are still working may be eligible for disability benefits or may be able to use benefits offered under the federal Family and Medical Leave Act, which allows up to 12 weeks of unpaid, job-protected leave each year for family and medical reasons with continuation of group health insurance coverage.

People who need to leave their job may be able to retain employer-sponsored healthcare coverage for as long as 36 months (depending on the circumstances) under the federal law COBRA.

Pension plans and retirement accounts can typically be drawn from before retirement age if you have a disability as defined under the plan or account’s guidelines.

• Early-onset Alzheimer’s is a rare form of the disease that causes loss of cognitive function beginning in a person’s fifties, forties, or even thirties.
• In most cases, there is no clear cause of early-onset Alzheimer’s. But sometimes a single inherited genetic variant causes the condition, which may be the case if you have a strong family history of Alzheimer’s.
• There’s no cure for early-onset Alzheimer’s, but medical treatments and lifestyle measures can help you preserve cognitive function and quality of life for as long as possible.

Additional reporting by Quinn Phillips.