THURSDAY, Aug. 25 (HealthDay News) -- Alzheimer's disease is one
of the most dreaded afflictions of old age, but the announcement by
celebrated women's basketball coach Pat Summit of her Alzheimer's
diagnosis at age 59 has put a spotlight on the less common, but
perhaps even more devastating, form of the disease.
About 500,000 people in the United States, or about 5 percent of
those with Alzheimer's, have early-onset Alzheimer's, also called
"young-onset" because it's diagnosed before age 65, said Dr. Zoe
Arvanitakis, a neurologist in the Alzheimer's Disease Center at
Rush University Medical Center in Chicago. Though rarer still,
diagnoses among people in their 30s and 40s aren't unheard of, she
noted.
"In contrast to what many people think, Alzheimer's disease does not only affect older persons. It can also affect persons in their middle adult ages," Arvanitakis said.
Symptoms for early-onset Alzheimer's are the same as for
late-onset disease, experts said. Summit, coach of the University
of Tennessee Lady Vols, told the
Washington Post this week that she suspected her
forgetfulness was a side effect of a rheumatoid arthritis drug,
until Mayo Clinic doctors told her she was showing mild signs of
the dementia.
Typically, early-onset Alzheimer's progresses more quickly than
late-onset Alzheimer's, experts said.
Still, the time from which a person first has symptoms to the
time they've lost so much of their mental abilities that they're
truly disabled varies widely from person to person, said Dr. Gary
Kennedy, director of the division of geriatric psychiatry at
Montefiore Medical Center in New York City.
For older patients, that may be 10 to 15 years; for younger
ones, time to disability is usually around five years, Kennedy
said.
Younger patients also have a different set of worries than older
patients. Many are still working, have mortgages and even families
to support, Arvanitakis said.
Recently, a change in federal law enabled patients with
early-onset Alzheimer's to receive Social Security disability
insurance (SSDI) and supplemental security income (SSI) more
easily, Arvanitakis said.
"There used to be significant roadblocks," she said. "I remember five, 10 years ago trying to help my patients get on disability being told, 'What proof do you have they have Alzheimer's disease?' It was hard for me to convince them it was true."
Because it's relatively uncommon, people in their 40s and 50s
with Alzheimer's can have difficulty getting a diagnosis. Apathy
and loss of interest in things once enjoyed can be one symptom of
Alzheimer's. But that's sometimes mistaken for depression,
Arvanitakis said.
Several gene mutations are believed to contribute to Alzheimer's
in younger people, and early-onset Alzheimer's can run in families
that have a hereditary component. But for other people, what causes
Alzheimer's is unknown, experts said.
In addition to having a close family member such as a mother,
father or sibling with early-onset Alzheimer's, having a major
depressive episode as an adult also appears associated with going
on to develop Alzheimer's, Kennedy said. Many people with Down
syndrome also eventually develop the disease.
There are no medications that can slow or reverse the underlying
biological processes that lead to damage in the brain. But like
older people, younger people can benefit from certain drugs that
boost levels of a neurotransmitter in the brain that is important
for forming memories, Arvanitakis said.
Those who fare the best tend to be those who have a strong
support system of family and friends, she said.
High blood pressure, stroke, diabetes, heart rhythm
abnormalities and high cholesterol can reduce blood flow to the
brain and lead to "vascular dementia," another form of progressive
decline in memory and thinking skills, Kennedy said. Research has
shown that many people with Alzheimer's also have vascular changes
in the brain.
To combat that, "it makes good sense to follow a heart-healthy
lifestyle," he said.
Those who are intelligent and educated also have brain
"reserves" that they can use to cope with the brain degeneration
and continue to function, at least for a time, Kennedy said.
"They have the software to compensate for what's happening to the hardware in the brain," Kennedy said.
And although the disease is relentless and people continue to
lose memory and thinking abilities, there is often time before that
happens to work, to accomplish things and to enjoy life,
Arvanitakis added.
"If you're the type of person who is energetic and wants to fight it and do everything possible, we do have patients that live with this diagnosis for many years and continue to lead a fulfilling and productive life," she said.
Summitt is nothing if not determined. She's won more victories
than any other college coach, men's or women's, and eight national
titles. According to news reports, Summitt has said she does not
believe her symptoms are severe enough for her to step down as
coach, and that her goal is to coach at least three more years, if
possible.
She also told her team about her condition, according to the
Washington Post.
"I just want them to understand that this is what I'm going through, but you don't quit living," she said. "You keep going."
Experts praised Summitt for sharing her struggle with the
public.
"When you're a very public figure and you share something so personal like your own illness, it brings attention to it, and bringing attention to this devastating illness might benefit others," Arvanitakis said. "It could mean more research will be done on it. It will be recognized earlier and people could have access to treatment earlier."
More information
The
U.S. National Institute on Aging has more on
early-onset Alzheimer's.