Is That 'Midlife Crisis' Really Alzheimer's Disease?

By Tartaglia, Carmela; Clinician-Scientist et al. | The Canadian Press, September 12, 2018 | Go to article overview

Is That 'Midlife Crisis' Really Alzheimer's Disease?


Tartaglia, Carmela, Clinician-Scientist, University Health Network and Associate Professor, Toronto, University of, The Canadian Press


Is that 'midlife crisis' really Alzheimer's disease?

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This article was originally published on The Conversation, an independent and nonprofit source of news, analysis and commentary from academic experts. Disclosure information is available on the original site.

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Author: Carmela Tartaglia, Clinician-Scientist, University Health Network and Associate Professor, University of Toronto

Imagine you tell your 55 year-old mom you're going to get married and she's too disorganized to help you with the wedding preparations. Or you put your kids on the bus to elementary school and the 57 year-old driver forgets the route.

These are real scenarios, drawn from my clinical work with patients who have young-onset Alzheimer's disease.

This is the other face of dementia -- no white hair or wrinkles. And it is relatively common. Approximately five per cent of Alzheimer's patients are younger than 65.

While the underlying pathology of both young-onset and late-onset Alzheimer's is the same -- the abnormal accumulation of proteins called amyloid and tau in the brain -- there are significant differences in how the two diseases are experienced.

Patients who are under 65, for example, often have difficulties with language, visual processing and organizing and planning. They have less of the classic memory complaints.

There is also accumulating evidence that young-onset Alzheimer's progresses faster.

Dementia confused with depression

The path to a diagnosis of Alzheimer's or other dementia is often long, meandering and riddled with misdiagnosis.

A correct diagnosis is essential for every patient but especially important for younger people. They are often still working and at risk of losing their jobs. They may have young children. When they tell people that something isn't quite right, they are told they are depressed or must be going through a midlife crisis.

Many times, younger patients will notice changes in their cognition at very early stages. They may notice increased difficulty in organization or planning. They may forget how to do complex tasks or forget appointments. Cognitive impairment is more obvious when completing highly demanding tasks at work or co-ordinating family logistics.

When a young person goes to see their doctor and reports such changes in cognition, the "d" word brought up is usually depression and not dementia.

Until the correct diagnosis is made, there can be many misinterpretations of their changes in thinking -- resulting in conflicts with family, friends and colleagues. …

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