Thursday 19 September 2019

Dear Doctor: Could my mum have early onset Alzheimer's?

Dr Jennifer Grant answers your health queries...

"I have noticed she is getting very forgetful and repeats herself. My dad and siblings have noticed it too but my dad thinks it’s nothing to worry about."

Dr Jennifer Grant

My mum recently turned 50 and I have noticed she is getting very forgetful and repeats herself. My dad and siblings have noticed it too but my dad thinks it’s nothing to worry about. I think she might have early onset Alzheimer’s, or is she too young for that? I am very worried.

Answer: At 50 years old your mum could be at risk of early onset dementia defined as onset of dementia age 30 to 65 years. Alzheimer disease (AD) is the most common form of dementia and the cardinal symptom of AD is recent episodic memory loss such as forgetting where you parked your car or what you did in the past few days. While both remote (distant) memory consolidated over years and procedural memory remain preserved for a considerable length of time. Other early symptoms include difficulty with word-finding during a conversation, mood or behavioural disturbances, repeating tasks over and over and loss of interest in doing things you normally enjoy. 

Although AD is highly heritable, particularly the early onset type, the genetic risk still remains poorly understood, despite decades of research. AD accounts for about 60-80pc of dementia. Even in the early onset type of AD the three best known genetic mutations account for less than 1pc of all cases of early onset AD. In order to consider yourself at higher risk you need to have at least three affected individuals in two or more generations, with two of the individuals being first-degree relatives (parent or sibling) of the third. 

It is critical that you get the perspective of someone who knows your mum well such as your dad and siblings. You mentioned that she repeats herself a lot and that makes me wonder how her hearing is? It is quick and cheap to get a hearing test in your local optician and consider hearing aids if indicated. You could perform a simple screen at home in the form of the ‘three-word recall’ memory test by asking your mum to repeat three words after you, for example ‘ball, car, tree.’ Tell her you will ask her to repeat these three words in 5-10 minutes and in the mean time you should aim to distract her. If she can remember all three words I would be less concerned. Nevertheless, if you are still having concerns you should ask her permission to have both of you attend her GP together.

 

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