“Are the risk factors for early onset Alzheimer’s the same as late onset?” asks Domenico Praticò, MD, the Scott Richards North Star Foundation Chair for Alzheimer’s Research, Professor in the Departments of Pharmacology and Microbiology, and Director of the Alzheimer’s Center at Temple (ACT), at the Lewis Katz School of Medicine at Temple University (LKSOM).

“A recent paper in JAMA Neurology from a study of patients in the UK identified risk factors for Young-Onset Dementia that include many which are readily treatable or modifiable,” says Praticò. “We know what we can do about Late-Onset Dementia and implement the same measures for the early-onset type. But, if those at risk for the Young-Onset type include different risk factors than what we are looking for with Late-Onset, there may be more preventative options to consider.”

“In most cases, Alzheimer’s disease develops after 65 as a result of multiple factors, which, over time, progress to decline of memory, cognitive and executive abilities. This form of the disease is commonly known as late-onset Alzheimer’s disease. Decades of studies have identified several risk factors for it, some of which are defined as ‘not modifiable.’”

“The conventional wisdom has been that the onset of dementia before the age of 65, defined as early-onset, follows a similar course, just earlier in life. Particularly with the incidence of early-onset Alzheimer’s as a result of DNA mutation is known as genetic or familial Alzheimer’s disease, the outcome appears to be predictable. This sense of inevitability that, if one inherits one of these mutations, has caused this specific form of Dementia to be investigated less.” 

“However, in recent years we have witnessed a significant increase in cases of dementia that start well before 65 and which are not genetic. Considering that the age of the individuals with early onset typically ranges from 45 to 64, it is obvious that they represent a big portion of what is considered the active component of the workforce within a society. With this concept in mind, it is easy to understand that this new clinical observation could have potentially a huge socio and economic impact on the entire society.” 

“One important question regarding these subjects not fully answered is: Are the risk factors for early onset Alzheimer’s the same as late onset?”

“What Hendricks demonstrated in the UK study with 40- to 64-year-olds with early onset dementia was a more full picture of increased risk factors. Their work revealed an association between  higher incidence of young-onset dementia and orthostatic hypotension, depression, Vitamin D deficiency, high c-reactive protein, and social isolation.”

“The study is very interesting for three reasons. First, for focusing on a less investigated form of dementia; second, for bringing to light previously unconsidered risk factors such as social isolation and depression, and finally, for confirming that, like for the late onset dementia, Vitamin D deficiency, high c-reactive protein and orthostatic hypotension are indeed to be considered risk factors.”

“Importantly, like for the late onset dementia interventions aiming at correcting these modifiable risk factors can be easily implemented. Although the published study did not address this aspect, it is fair to predict that like for the late onset, by correcting these risks (social isolation, depression, etc.) a significant number up to 30 to 40 % of all cases of early onset dementia could be reduced and or prevented. This result would have a worldwide tremendous impact on the health systems, the socio-economic structure and most importantly the regular daily life for many families. Let’s not forget that the subjects who develop the non-genetic early onset dementia are probably fathers or mothers of young children or grandparents of young grandchildren.”