TUESDAY, April 15 (HealthDay News) -- The root cause of
early-onset dementia is usually not Alzheimer's, but rather another
neurodegenerative or autoimmune disorder, new research
suggests.
The study authors acknowledge that -- age aside -- the most
common forms of dementia are Alzheimer's disease, vascular dementia
and the brain damage-associated condition known as Lewy body
dementia. However, their current work indicates that among patients
below the age of 45, the problem is much more likely to be traced
back to diseases such as multiple sclerosis, Huntington's, lupus or
HIV infection, among others.
"This is really a novel finding, because there hasn't really
been a study that's looked at young-onset dementia in this way,"
said study author Dr. Brendan J. Kelley, a neurologist at the Mayo
Clinic in Rochester, Minn. "And the message is that young-onset
dementia is generally not related to Alzheimer's."
The work of Kelley and his team was expected to be presented
April 15 at the American Academy of Neurology annual meeting, in
Chicago.
The U.S. Administration on Aging highlights 2006 estimates
released by the Alzheimer's Association, which indicate that
between 220,000 and 640,000 American men and women currently suffer
from early-onset dementia. The association specifically defines
"early-onset Alzheimer's" as referring to cases that develop before
the age of 65.
However, in their study, Kelley and his team focused exclusively
on 235 patients diagnosed with a form of dementia diagnosed between
the ages of 17 and 45 -- citing statistics suggesting that 12 in
100,000 people develop some form of early-onset dementia before the
age of 45.
All the study patients had sought care at the Mayo Clinic
between 1996 and 2006, and all had normal cognitive function prior
to their dementia diagnosis.
A medical record analysis revealed that despite the fact that
most adult dementia is a function of Alzheimer's, less than 2
percent of the cases among the under-45 group was attributable to
that disease.
Kelley and his colleagues found that other neurodegenerative
conditions -- such as frontotemporal dementia, a group of diseases
commonly misdiagnosed as Alzheimer's -- were at play in almost
one-third of the cases.
Autoimmune and inflammatory disorders -- such as MS -- accounted
for just over 20 percent of the dementia cases. Metabolic
abnormalities were cited in just over 10 percent of the diagnoses,
while for another 20 percent, no cause for dementia could be
established.
Kelley said his work is ongoing. And he added that he and his
colleagues are now trying to identify specific disease markers for
early-onset dementia to help physicians distinguish those cases
prompted by causes other than Alzheimer's.
"Because some of the other disorders linked to early dementia
have treatable profiles that allow targeting not just of the
symptoms but of the underlying disease process," he noted. "So, we
really should be looking to identify them quickly when they are the
cause, because the research suggests that treatment could result in
a direct improvement of the patient's cognition and behavior."
Greg M. Cole, associate director of the Alzheimer's Disease
Research Center at the UCLA David Geffen School of Medicine,
described the findings as "interesting, but not completely
unexpected".
"We know that Alzheimer's gets rarer and rarer the younger you
go," he said. "So, when you're focused as this study is on people
between 17 and 45 -- really before middle-age -- it's more likely
you'll find some other cause for the dementia, which can be a
variety of different things."
"But if you're looking at these other autoimmune causes --
multiple sclerosis, lupus, HIV -- the real question is, can you
treat any of this?," pondered Cole. "Because you can get lupus and
MS to go into remission. So, in this case, if patients are getting
dementia caused by either disease, can the dementia also go into
remission? If they can get that to happen, that would be very
interesting."
More information
For additional information on early-onset Alzheimer's, visit the
U.S. Administration on Aging.