He discovers he has Alzheimer’s at 19: the unique case that opens up a new scenario on the disease

Cases of early Alzheimer’s are rare, although the phenomenon in recent years has already been recorded and examined by the scientific community.
“Early”, in the specific case of Alzheimer’s, means having encountered the appearance of the first symptoms of the disease – which in general it affects men and women over the age of 65 – on individuals under the age of 30. All the early cases found have always been linked to a genetic predisposition, as was also the case for the 21-year-old who up to now had been the youngest ever Alzheimer’s patient.

now, however, the case of the 19-year-old with presumed Alzheimer’s disease, the subject of study at the Capital Medical University of the Xuan Wu Hospital in Beijing, is opening a new scenario on the onset of the disease. Two years before the hospital consultation, the teenager had had to drop out of high school due to severe difficulty concentrating. His situation worsened when he started to suffer from apparent short-term memory loss: he couldn’t remember the previous day’s events or where his belongings were stored, he had difficulty reading and his reactions were delayed. . His memory, in practice, was gradually declining: he often lost personal belongings, could not remember whether he had eaten or not and could not finish his homework. For this, in the end, he had to withdraw from high school.
From the analyzes carried out, the researchers therefore found typical characteristics of Alzheimer’s disease in the patient, including memory loss and thehippocampal atrophya condition that is an early marker of the disease.
However, the adolescent patient protagonist of the Chinese study differs from all previous young Alzheimer’s patients for a specific reason: in his case no genetic mutations have been identified. It would therefore be the first case in the world of Alzheimer’s disease diagnosed at this age, in a non-predisposed subject.

“This is the youngest case ever reported for probable Alzheimer’s disease without recognized genetic mutations,” the study authors highlighted, reiterating that nearly all of the previous younger patients, under the age of 30, had known genetic mutations.
This case therefore highlights the heterogeneous nature of dementia that can affect people of any ageuntying Alzheimer’s disease from the complexity of aging.
But while the latest evidence suggests there may be an increase in the incidence of early-onset Alzheimer’s disease, it may simply be an increased recognition of the disease.
We investigated the case with the Professor Albert Albanian, head of Neurology of IRCCS Humanitas Clinical Institute and professor at Humanitas University. “This is a single case that can indicate both an important discovery and something that will not be repeated. It’s definitely not a common occurrence, especially at this age. What we know statistically is that the earlier the symptoms are, the more likely there is a genetic predispositionfor this reason the researchers focused on the analysis of the known genes, although they did not find a match”

So what could be the cause of such an early manifestation?
«The genetic hypothesis remains in the foreground, but up genes not yet identified. This guy could be the bearer of a new genetic variant, not yet known and this obviously could open up an interesting perspective for research. Obviously, it is difficult to obtain a lot of data on a single case, probably it is being studied in detail to look for analogies with other conditions. It is clear, however, that if the number of cases increases, we can move faster towards new discoveries, and I personally believe they must be linked to genetic aspects that have not so far been linked to Alzheimer’s.

Is it to be excluded that there may be other causes that trigger the early symptoms of the disease?
“No, it can’t be ruled out. In addition to genetic causes there are also environmental factors that can play a very important role in all degenerative diseases, Alzheimer’s such as Parkinson’s or motor neuron disease. Obviously there are strong, deterministic genes that express themselves even at a young age and strong, deterministic environmental causes that express themselves after a not necessarily very long exposure».

What environmental factors, in particular, can affect neurological degeneration?
«They can be viruses, some bacteria but also toxic substances. There was a case in California that saw the development of a Parkinson’s epidemic in 25-year-old drug addicts who had taken MPTP, a neurotoxic substance that causes symptoms similar to Parkinson’s disease. More generally, many causes are still poorly understood because it is obviously easier to study genes, while environmental factors can have a temporary influence and the effects appear after a few years. The reconstruction of the environmental exposure in this case is therefore more difficult».

What should we expect from this Chinese discovery?
«The case of this 19-year-old was classified as “probable”, and this in our scientific language indicates a lower level than the certain, the definite. It is an intermediate level, but not low, because evidently the biochemical parameters obtained suggest a strong analogy with what occurs in Alzheimer’s disease. The hope is that these single cases can open new doors, that they are the front office of a new discovery. They are important to give hope to researchthey must not become a cause for anguish”.

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