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HomeCase ReportYoungest person ever diagnosed with Alzheimer’s – Chinese study

Youngest person ever diagnosed with Alzheimer’s – Chinese study

In 2023, neurologists at a memory clinic in China diagnosed a 19-year-old with what they believed to be Alzheimer’s disease, making him the youngest person ever to be diagnosed with the condition in the world.

The teenager began experiencing memory decline at around the age of 17, and the cognitive losses only worsened over the years.

Imaging of his brain showed shrinkage in the hippocampus, which is involved in memory, and his cerebrospinal fluid hinted at common markers of this most common form of dementia.

Alzheimer’s is often thought of as an old person’s ailment, and yet early-onset cases, which include patients under 65, account for up to 10% of all diagnoses.

Almost all patients under 30 can have their Alzheimer’s explained by pathological gene mutations, putting them into the category of familial Alzheimer’s disease (FAD), reports Science Alert. The younger a person is when they receive a diagnosis, the more likely it is the result of a faulty gene they’ve inherited.

Yet researchers at the Capital Medical University in Beijing couldn’t find any of the usual mutations responsible for the early onset of memory loss, nor any suspect genes when they performed a genome-wide search.

Before this diagnosis in China, the youngest patient with Alzheimer’s was 21-years-old. He carried the PSEN1 gene mutation, which causes abnormal proteins to build up in the brain, forming clumps of toxic plaques, a common feature of Alzheimer's.

Cases like the one in China pose something of a mystery. None of the 19-year-old’s family had a history of Alzheimer’s or dementia, making it hard to categorise as FAD, yet the teen had no other diseases, infections, or head trauma that could explain his sudden cognitive decline either.

Two years before being referred to the memory clinic, he began struggling to focus in class. Reading also became difficult and his short-term memory declined. Often, he couldn’t remember events from the day before, and he was always misplacing his belongings.

Ultimately, the cognitive decline became so bad, the young man was unable to finish high school, although he could still live independently.

A year after being referred to the memory clinic, he showed losses in immediate recall, short-delay recall after three minutes, and long-delay recall after 30 minutes.

The patient’s full-scale memory score was 82% lower than that of peers his own age, while his immediate memory score was 87% lower.

Long-term follow-up is needed to support the young man’s diagnosis, but his medical team said at the time the patient was “altering our understanding of the typical age of onset of AD”.

“The patient had very early-onset AD with no clear pathogenic mutations,” neurologist Jianping Jia and colleagues wrote in their study, “which suggests its pathogenesis still needs to be explored.”

The case study, published in February 2023, just goes to show that Alzheimer’s doesn’t follow a single pathway, and is much more complex than we thought, emerging via numerous avenues with varying effects.

In a statement, the neurologists who described the patient’s case argued that future studies should focus on early-onset cases to further improve our understanding of memory loss.

“Exploring the mysteries of young people with Alzheimer’s disease may become one of the most challenging scientific questions of the future,” they said.

The study was published in the Journal of Alzheimer’s Disease.

Study details

A 19-Year-Old Adolescent with Probable Alzheimer’s Disease

Jia, Jianpinga, Zhang, Yuea, Jia, Longfeia et al.

Published in Journal of Alzheimer’s Disease on 31 January 2023

Abstract

Alzheimer’s disease (AD) primarily affects older adults. In this report, we present the case of a 19-year-old male with gradual memory decline for two years and World Health Organisation-University of California Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) results also showing memory impairment. Positron emission tomography-magnetic resonance imaging with 18F fluorodeoxyglucose revealed atrophy of the bilateral hippocampus and hypometabolism in the bilateral temporal lobe. Examination of the patient’s cerebrospinal fluid showed an increased concentration of p-tau181 and a decreased amyloid-β 42/40 ratio. However, through whole-genome sequencing, no known gene mutations were identified. Considering the above, the patient was diagnosed with probable AD.

 

Science Alert article – The sad case of the youngest person ever diagnosed with Alzheimer’s (Open access)

 

Journal of Alzheimer’s Disease article – A 19-Year-Old Adolescent with Probable Alzheimer’s Disease (Open access)

 

See more from MedicalBrief archives:

 

Blood test to accurately predict early Alzheimer’s

 

ADHD linked to increased dementia risk across family generations

 

Memory changes may predate Alzheimer’s onset by 40 years

 

 

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