In a groundbreaking case, neurologists at a memory clinic in China diagnosed a 19-year-old with Alzheimer’s disease, marking him as the youngest person ever to receive this diagnosis. The young man first noticed memory decline at age 17, with symptoms progressively worsening. Brain scans indicated significant shrinkage in the hippocampus, a critical area associated with memory, while analyses of cerebrospinal fluid revealed biomarkers typically linked to Alzheimer’s, the most prevalent form of dementia.
Understanding Early-Onset Alzheimer’s
Alzheimer’s disease is traditionally associated with older adults, but early-onset cases, defined as those occurring in individuals under the age of 65, account for approximately 10 percent of all diagnoses. Within this demographic, the majority of Alzheimer’s patients under 30 are diagnosed with familial Alzheimer’s disease (FAD), which is primarily driven by hereditary genetic mutations. Notably, the younger a patient is at diagnosis, the more likely the condition is due to an inherited genetic mutation.
Despite these trends, researchers from Beijing’s Capital Medical University faced an unusual challenge with this case. Their genome-wide search revealed no known mutations responsible for early-onset Alzheimer’s, nor any suspect genes. Neurologist Jianping Jia and his team noted, “This is the youngest case ever reported to meet the diagnostic criteria for probable Alzheimer’s disease without recognized genetic mutations.” Prior to this diagnosis, the youngest recorded Alzheimer’s patient was 21 years old and carried the PSEN1 gene mutation, known for leading to toxic protein buildup in the brain.
A Unique and Mysterious Case
The case is further complicated by the fact that the teenager’s family had no history of Alzheimer’s or dementia, making it difficult to classify the condition as FAD. Additionally, the young man had no other medical issues, infections, or history of head trauma that could explain his sudden and severe cognitive decline.
In the two years leading up to his referral to the memory clinic, the patient experienced significant difficulties in concentration during classes, struggled with reading, and faced short-term memory loss. He frequently misplaced belongings and had trouble recalling events from the previous day. Ultimately, his cognitive impairment became so profound that he could not complete his high school education, despite retaining the ability to live independently.
After being referred to the memory clinic, the patient exhibited deficits in immediate recall, short-delay recall after three minutes, and long-delay recall after 30 minutes. His full-scale memory score was found to be 82 percent lower than that of his peers, while his immediate memory score was 87 percent lower.
Long-term follow-up will be essential to confirm the diagnosis, but the medical team indicated that this case could “alter our understanding of the typical age of onset of Alzheimer’s disease.” They reported that the patient had early-onset Alzheimer’s disease without identifiable pathogenic mutations, suggesting a need for further exploration into the disease’s origins.
Published in the Journal of Alzheimer’s Disease in February 2023, this case emphasizes the complexity of Alzheimer’s, indicating that it does not adhere to a single pathway. The findings highlight the necessity for future research into early-onset cases, as understanding these mysteries may represent one of the most significant scientific challenges in the years to come.
In a statement to the South China Morning Post, the neurologists expressed the importance of investigating young individuals with Alzheimer’s, stating, “Exploring the mysteries of young people with Alzheimer’s disease may become one of the most challenging scientific questions of the future.”
