Youngest Alzheimer’s patient diagnosed in China

A teenager in China is the youngest person ever diagnosed with probable Alzheimer’s disease, according to a study published on December 31 by the doctors who diagnosed it.

Alzheimer’s disease is a degenerative disease that affects thinking, memory and behavior. The overwhelming majority of patients with Alzheimer’s disease are over 65, which makes this case particularly exceptional.

The study, published in the alzheimer’s journal, describes how the 19-year-old, whose name has not been identified, began showing signs of memory loss two years before he was referred to the Neurological Disorders Innovation Center and Department of Neurology at Xuanwu Hospital in Beijing.

He had started having difficulty concentrating on his high school studies two years earlier and had begun to suffer from short-term memory loss a year earlier.

“For example, he could not remember the events of a day or the location of his personal belongings,” the authors wrote. “He also had difficulty reading and reacting.”

Gradually, the teenager’s memory deteriorated. The authors wrote that he often lost his things, couldn’t remember if he had eaten, and had trouble describing the content he had just read.

Due to his worsening condition, he had to drop out of high school. Prior to the onset of his symptoms, he was considered an above average student.

A LITANY OF TRIALS

Once the teenager was referred to Xuanwu Hospital, doctors handling his case delved into his medical and family history and performed a litany of tests looking for clues about his condition.

They found that his childhood development had been normal and that neither his parents, grandparents, nor relatives had a history of dementia, cognitive decline or psychiatric illness.

He had no history of head trauma, psychiatric or psychological disorders or illnesses related to memory decline, and doctors ruled out other common causes of cognitive impairment in young people, including inflammation, infection , poisoning, abnormal metabolism, trauma and “congenital anomalies”. “

The teenager underwent a wide range of neuropsychological tests for mental status, memory, dementia, anxiety and depression, as well as MRIs and CT scans, blood and urine and brain fluid tests -spinal and a tau tracer to search for tau tangles.

Tau is a protein that supports neurons, or nerve cells, in the brain. Abnormal accumulation of tau, particularly in protein tangles, is a hallmark of Alzheimer’s disease.

His spinal fluid showed abnormal tau buildup and his MRI showed atrophy – the loss of nerve cells and the connections that help them communicate in brain tissue – in his hippocampus.

He also scored below average on the auditory verbal learning test from the World Health Organization and the University of California, Los Angeles, suggesting he suffered from significantly impaired memory.

Doctors sequenced the teen’s genes and those of his family members to look for mutations associated with early onset Alzheimer’s disease, but found none.

A RARE DIAGNOSIS

Even in the absence of these mutations, they made their diagnosis.

“This is the youngest case ever reported to meet the diagnostic criteria for probable (Alzheimer’s disease) with no recognized genetic mutations,” they wrote.

Previously, they explained, the youngest person diagnosed with the disease was 21.

Early-onset Alzheimer’s disease affects people under the age of 65 and is rare, accounting for between 2 and 8%, or 28,000, of all known cases in Canada, according to the Alzheimer Society of Canada.

The disease can occur sporadically – through a combination of genetics, aging and environment – ​​or through pathological mutations in genes.

Younger patients tend to carry these genetic mutations, as was the case for the youngest person previously diagnosed with Alzheimer’s disease. The specialists were therefore intrigued by the diagnosis of the teenager and the absence of mutations. They wrote that his case changed their “understanding of the typical age of onset of (Alzheimer’s disease).”

The authors did not specify what types of treatment or support their young patient will receive, but said they plan to follow him long-term to better understand the disease.