Recognizing And Coping With Early Onset Dementia

While dementia is typically associated with older adults, it can also affect people younger than 65 years old. This is usually referred to as early-onset or young-onset dementia and can be characterized by symptoms involving diminished cognitive function, like working memory problems and problem-solving difficulties. Early-onset dementia can also feature disturbances in one’s emotions that can severely impact daily function. 

People with early-onset dementia may experience financial challenges and obstacles at work or school. They might have trouble keeping up with daily responsibilities, particularly if there are challenges with driving or difficulties with following directions. Changes in mood and emotional expression can create significant problems in relationships. 

However, with prompt intervention, people with early-onset dementia may manage their symptoms and maintain their overall well-being. Therapy can be helpful for learning effective coping strategies.

Signs of early-onset dementia

Recognizing early-onset dementia can be challenging, as signs often vary. Additionally, conditions like thyroid problems, certain cancers, and sodium or vitamin B12 deficiency can come with dementia-like symptoms.

Over time, these symptoms might increase in severity. Mood swings and changes in behavior may become more intense, and individuals may develop additional symptoms, such as paranoia or distrust of family, friends, and caregivers. Memory and cognitive awareness might decline more rapidly, and individuals might develop trouble with motor skills, such as swallowing or walking. 

Early-onset dementia diagnosis 

Diagnosing early-onset dementia typically involves a comprehensive evaluation by a healthcare professional. Although it can be critical for proper treatment, establishing an accurate dementia diagnosis in younger people may be more challenging for a few reasons. 

Early onset Alzheimer’s disease

For example, conditions like early-onset Alzheimer’s that cause early-onset dementia usually aren’t as common, and some healthcare professionals might not have the expertise required to identify them. Additionally, dementia symptoms aren’t always obvious and can mistakenly be attributed to mental health challenges like chronic stress or depression.

Early-onset dementia assessment 

The assessment and diagnostic process for early-onset dementia typically involves multiple steps, including, but not limited to, the following: 

• A review of the individual’s medical history, including any family history of dementia or other cognitive disorders
• A thorough physical examination, including blood tests and other lab work
• A neuropsychological evaluation to assess memory, language, reasoning, attention, and other cognitive functions
• Brain imaging studies to provide a picture of the brain’s structure and function
• Genetic testing, especially if there is a family history of dementia

Early evaluation by a professional can influence successful treatment outcomes, potentially helping individuals and families better manage their condition, get appropriate support services, and plan for the future. 

What causes early-onset dementia?

When exploring the causes of dementia, it might be prudent to consider that it isn’t a disease but a term describing a set of symptoms. Thus, there are several possible causes for early-onset dementia, the most common being Alzheimer’s disease (AD), with an estimated 70% to 80% prevalence rate. Below are other potential causes in order of prevalence.

Frontotemporal dementia (FTD)

FTD tends to be more commonly seen in cases of early-onset dementia than dementia in individuals over age 65. It is usually caused by damage to neurons in the brain’s frontal and temporal lobes. The causes of FTD are currently unknown. However, scientists believe it may be genetic in some people. 

Vascular dementia

This term generally refers to dementia resulting from damage to blood vessels that reduces oxygen and nutritional circulation in the blood. Diminished vascular function can be caused by stroke, small vessel disease, or transient ischemic attacks, also known as “ministrokes.” 

Parkinson’s disease

Parkinson’s disease, normally caused by diminished dopamine production in the brain, is another potential source of dementia. Parkinson’s dementia often emerges in the later stages of the disorder, after physical symptoms like problems with coordination and tremors have arisen.

Lewy body dementia

This type of dementia can be caused by a buildup of protein deposits (Lewy bodies) in the brain’s nerve cells. Research suggests that Lewy body accumulation may be linked to a loss of specific brain neurons that carry the neurotransmitters acetylcholine and dopamine. 

Early-onset dementia and Alzheimer’s disease risk factors

A recent study published in The Journal of the American Medical Association (JAMA) reveals there are several potential risk factors for early-onset dementia. 

In the study, researchers from the Netherlands and the United Kingdom monitored roughly half a million individuals aged 37 to 73. They found that 485 participants developed early-onset dementia within a decade of the survey.

After comparing participants who developed early-onset dementia with those who did not, they identified 15 factors linked to a higher risk of early-onset dementia. Out of these, the researchers isolated eight factors that were most strongly associated with early-onset dementia:   

Risk factors of early-onset dementia

• Genetics: Some gene alleles appear to be linked to familial Alzheimer’s disease, a primary cause of dementia.

• Alcohol use disorder (AUD): AUD can cause damage to the frontal lobes, leading to problems with executive function and working memory.

• Vitamin D deficiency: Deficiencies in vitamin D can be linked to increased risk for dementia.

• Heart disease/prior stroke: Heart disease can be a common risk factor for stroke. Damage to the brain from a stroke can cause vascular dementia.

• Social isolation: Although the underlying mechanism is currently unknown, isolation could be a significant risk factor for dementia. Scientists believe it may be related to how social interactions stimulate brain function. 

• Poor hearing: While more research may be required to determine a conclusive link, studies indicate that poor hearing could result in reduced brain stimulation and lack of social interaction, potentially increasing the risk of dementia. 

• Diabetes in male participants: Research suggests that middle-aged men are at greater risk of health conditions that contribute to vascular dementia. 

Early-onset dementia treatments

While there is no current cure for early-onset dementia, a combination of medications, cognitive therapy, lifestyle modifications, and support services can help individuals slow its progression, effectively manage symptoms, and improve overall well-being. Below are a few standard treatment approaches for early-onset dementia.

Medication

Doctors may prescribe cholinesterase inhibitors, memantine, and antidepressants or antipsychotics as part of treatment. These medications must be carefully monitored, and it can be vital to inform your prescribing provider if you’re experiencing any side effects.

Have you received an early-onset dementia diagnosis?

Online therapy can help you cope

Therapy and other interventions for early onset dementia

The following interventions may be used in tandem with medication.

• Cognitive therapy: Cognitive therapy generally focuses on helping people with early-onset dementia maintain cognitive function, manage symptoms, and improve overall well-being. 

• Cognitive rehabilitation: This might include memory exercises, problem-solving tasks, and activities to enhance attention and executive function.

• Cognitive stimulation therapy (CST): This can be defined as a structured program of group activities and exercises to stimulate thinking, concentration, and memory. 

• Behavioral interventions: Behavioral interventions can help manage changes in behavior and mood associated with dementia. Techniques include behavioral activation, in which individuals engage in activities designed to reduce symptoms of depression and anxiety, and problem-solving therapy, in which individuals learn structured approaches to managing practical and emotional challenges.  

• Cognitive behavioral therapy (CBT): Cognitive behavioral therapy (CBT) usually adjusts unhelpful thought patterns in order to positively shift emotions and behaviors.

• Occupational therapy: Occupational therapists typically teach individuals strategies and introduce tools to maintain independence in daily activities. 

• Memory aids and assistive technology: Tools like memory notebooks, calendars, alarms, and smartphone apps can help individuals manage daily tasks and appointments.

• Education and support for caregivers: Education and support can be crucial for family members and caregivers. Such resources can help caregivers learn effective communication skills and strategies for supporting a loved one with dementia while managing their own mental health.

• Healthy lifestyle practices: Regular physical activity, nutritious eating habits, and good sleep hygiene can significantly impact an individual’s cognitive function and overall well-being.

Online therapy for early onset dementia

While psychotherapy can be an integral part of a comprehensive treatment strategy, people with dementia sometimes face challenges in getting the help they deserve. For example, some may experience obstacles associated with scheduling and availability. Others may assume that conventional psychotherapy is unaffordable.

Benefits of online therapy for memory loss and mental health

Though it might not be appropriate in all cases, some people find that virtual therapy can overcome many of the barriers associated with in-office treatment. For example, virtual therapy can give people greater scheduling flexibility and eliminate the need to commute to and from office appointments. 

Online therapy can provide people with early-onset dementia and their caregivers with a convenient, affordable, and effective alternative to traditional treatment.