Doctors in China have identified what is believed to be the world's youngest case diagnosed with Alzheimer's disease: A boy just 19 years old. The case has surprised the scientific community, as the disease usually affects the elderly and its onset at such a young age remains unexplained.
The young man, whose identity has not been made public, began experiencing memory loss at the age of 17. He would often forget what he had done the day before and would constantly lose personal belongings. Over time, the problems worsened to the point that he was unable to finish high school, although he was still able to live independently.
Before he was officially diagnosed with early-onset Alzheimer's, he was followed for about a year at a specialized memory clinic. There, it was noted that his overall memory score was 82 percent lower than his peers, while his immediate memory was 87 percent weaker.
In 2022, brain scans showed shrinkage of the hippocampus, a key area for memory formation and one of the first parts to be damaged in Alzheimer's — the most common form of dementia. Analysis of cerebrospinal fluid also revealed typical signs of the disease, including abnormal levels of the proteins amyloid and tau.
However, a detailed genetic analysis did not identify any known mutations typically associated with early-onset Alzheimer's. Almost all patients diagnosed under the age of 30 have specific genetic mutations, such as those in the PSEN1 gene, that lead to so-called familial Alzheimer's. This patient had no such mutations and no family history of dementia.
Researchers from Capital Medical University in Beijing, who described the case, stressed that the mechanisms of disease development still “need to be explored.” They suggest that as yet unknown genetic factors, specific environmental interactions, or new disease mechanisms not previously documented may be involved.
To date, the youngest known case of Alzheimer's was a 21-year-old with the PSEN1 mutation. In contrast, the 19-year-old's case is considered "sporadic," meaning without an identifiable genetic cause.
The case report, published in the Journal of Alzheimer's Disease, notes that despite the extremely young age, the patient met the diagnostic criteria for "probable Alzheimer's dementia," according to the standards of the National Institute on Aging and the Alzheimer's Association.
The deterioration was rapid and severe. Initially, difficulties with concentration appeared during high school, followed by profound short-term memory loss, an inability to remember everyday events, and difficulty retaining even a single paragraph of text.
Standard cognitive screening tests, at first, did not fully reveal the problem. He scored 28 out of 30 on the MoCA and 29 out of 30 on the MMSE, scores that are considered normal. But a year later, the decline in the memory portion of the MoCA became apparent. More specialized tests showed serious deficits: he could remember only 37 words after five immediate trials (the norm is about 56), only five words after three minutes, and only two words after 30 minutes, when the norm is about 13.
MRI scans confirmed shrinkage of the hippocampus and reduced activity in other brain areas associated with memory. While PET scans for amyloid and tau deposits were negative, analysis of cerebrospinal fluid proved more sensitive, revealing changes characteristic of Alzheimer's.
Numerous tests ruled out other possible causes, such as infections, autoimmune diseases, toxins, or metabolic disorders. Genetic testing found no mutations in the PSEN1, PSEN2, or APP genes. The patient had the most common, neutral form of the APOE gene, which does not significantly increase the risk of Alzheimer's.
Alzheimer's is usually considered a disease of the elderly, but recent studies suggest that cases in people under 50 are on the rise. A report from Blue Cross Blue Shield shows that diagnoses among insured adults, ages 30–64, increased by 200 percent between 2013 and 2017. The median age of those affected was 49, and women accounted for about 58 percent of cases.
Experts say this increase may largely reflect improved diagnosis, as cognitive symptoms in young people were previously often attributed to stress or fatigue. However, modern lifestyle factors — poor diet, lack of physical activity, excessive screen use and obesity — are being studied as possible contributors to the risk of dementia at a younger age, through inflammation, vascular damage and metabolic disorders that accelerate brain aging. /GazetaExpress/
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