Tony Gonzales, a Mexican American, knew something was wrong one day in 2021, when he was driving home from work. All of a sudden, he had no idea where he was. 

“Nothing looked recognizable, and I could not remember where I was coming from,” he said. After two years of going to doctors, he was diagnosed with early-onset Alzheimer’s  at the age of 47. 

While most people develop the disease after the age of 65, Gonzalez is one of about 300,000 Americans who get a type of Alzheimer’s that sets in earlier. In most cases, early-onset Alzheimer’s isn’t driven by genetics. But, large-scale clinical research into this early-onset form of Alzheimer’s is still limited, and scientists aren’t sure what causes it. 

The difference between early-onset and late-onset Alzheimer’s

While late-onset Alzheimer’s often starts as problems with memory loss, people who develop early-onset Alzheimer’s can develop a variety of symptoms early on that affect their attention, spatial awareness, and language abilities. 

People with early-onset Alzheimer’s might be more prone to developing anxiety, depression, and other behavioral symptoms. This might be because they might be more aware of the changes that are going on inside their brain.

There are also differences scientists have spotted in the brains of people with early-onset Alzheimer’s—they have higher levels of beta-amyloid plaques and tau tangles. Late-onset dementia might lead to shrinkage in the part of the brain responsible for memory called the hippocampus, while early-onset Alzheimer’s strikes another part of the brain first, the sulcal region.

People with early-onset Alzheimer’s may have their disease progress faster than those who first develop symptoms after the age of 65. Despite having all the same symptoms and the hallmark plaques and protein deposits in their brain, people who develop Alzheimer’s early also tend to have a more challenging time getting a proper diagnosis. 

Preventing and treating early-onset Alzheimer’s

It might be possible to reduce the chances of developing early-onset Alzheimer’s by making lifestyle changes, such as exercising or eating a diet that promotes heart and brain health. Scientists have also found links between early-onset Alzheimer’s and traumatic brain injury. So, for athletes, wearing a helmet or reducing how often you play sports like football, hockey, or boxing, where head injuries are common, can also help.    

Prevention is important, as is an early diagnosis, because there are treatments for Alzheimer’s symptoms, but no known treatments that can reverse or stop early-onset Alzheimer’s progression. And for those in very early stages of the disease, patients may have access to a new class of disease-modifying monoclonal antibody drugs, like Leqembi designed to slow progression by a small amount.