19-year-old teenagers diagnosed with Alzheimer's disease, "Alzheimer's" young people are increasing?

Recently, Professor Jia Jianping's team from Xuanwu Hospital of Capital Medical University published a paper in the international journal "Journal of Alzheimer's Disease", introducing a case of a 19-year-old boy who was clinically diagnosed with Alzheimer's disease, which attracted social attention. This is the youngest known patient with a clinical diagnosis of Alzheimer's disease.

Is there a younger trend in Alzheimer's disease? What are some inconspicuous phenomena that could be signs of illness? In life, how can we prevent it?

In this issue of "Doctor Goose Drop", let's see who "stolen" our memory?

1. Why do 19-year-old adolescents get Alzheimer's disease?

【Question 1】How was the patient discovered? What are the differences in his clinical presentation compared to other patients?

Jia Jianping: The discovery of this patient has gone through a very complicated process.

At the age of 17, he had memory loss, inability to concentrate, and comprehension impairment, but due to his age, it was difficult to accurately diagnose Alzheimer's disease and required a lot of examination and discussion.

In terms of clinical manifestations, first, memory impairment appeared.

Second, lumbar puncture reveals specific protein changes to diagnose Alzheimer's disease.

Third, there are symptoms of hippocampal atrophy.

Fourth, a CDR scale (Cognitive Decline Scale) score of 1 is mild dementia.

CDR scale

【Question 2】Is there a gene that may cause disease in this patient? What other factors may contribute to the onset? 

Jia Jianping: We found no disease-causing genes in the whole genome. Common Alzheimer's disease causative genes include PSEN1, PSEN2 and APP gene mutations, which this patient does not have.

Factors contributing to the onset of Alzheimer's disease include genetic, environmental, and aging factors. Genetic factors are divided into disease-causing genes and risk genes, of which the risk gene is mainly APOEc4, Chinese there are many people who carry this gene, about 20%, almost 270 million people (roughly calculated according to the total population of 1.4 billion), so the focus of prevention is on people who carry risk genes. Of course, it does not mean that the risk gene will necessarily develop the disease.

Environmental factors, including a healthy lifestyle and a harmonious home environment, can offset the risks posed by APOEc4.

In addition, the elderly are prone to Alzheimer's disease due to other underlying diseases and decline in physical function.

【Question 3】What is the current treatment status of this case?

Jia Jianping: At present, we know that the case has significantly improved after systematic treatment, such as a significant improvement in academic performance. After that, we will follow up the whole process, visit us every six months to understand the condition, respond to drugs, provide suggestions for cognitive training, and help build confidence in overcoming the disease.

【Question 4】What is the impact of the disease on the life, study and work of patients? What kind of support does his family need for him?

Jia Jianping: The disease has a great impact on life, especially memory impairment has a negative impact on study and work, and seriously affects the ability to live independently. And if the patient suffers from social discrimination and stigma, the situation worsens.

Family support is one of the important factors affecting the disease, harmonious family can bring spiritual warmth, and unharmonious family relationship has a negative impact on the healthy brain development and growth of children.

Source: Healthy China

Second, how to prevent and judge Alzheimer's disease?

【Question 1】How to judge the severity of Alzheimer's disease patients?

Jia Jianping: We judge the degree of cognitive impairment through the CDR scale. The scale is divided into 0123 grades, 0 means no disease, 0.5 means mild cognitive impairment, 1 represents mild dementia, 2 represents moderate dementia, and 3 represents severe dementia. By grading the condition, it can be treated precisely.

Clinical Dementia Scale for the Elderly (CDR Scale)

【Question 2】What are the warning signs of the disease? What should people with a family history pay attention to? 

Jia Jianping: Early warning signs include persistent memory impairment, memory impairment with risk genes, long-term poor lifestyle and memory impairment. If you have a family history, it is recommended to seek medical attention at a young age to detect the possibility of onset and maintain a healthy lifestyle. For ordinary people, there is no need to worry too much until the age of 50.

【Question 3】In your paper, you propose six healthy lifestyles, how can these six lifestyles help improve the disease? 

Jia Jianping: Six healthy lifestyles, including healthy diet, physical exercise, full social interaction, more brain use and control of tobacco and alcohol, can play a good role in protecting memory. We categorized the implementation into three levels: good, medium and poor, and an empirical study of 29,000 people found that the prevention effect of the group with good implementation was more than 60%. [1]

Do young people need to be concerned about the possibility of Alzheimer's disease?

【Question 1】Is Alzheimer's disease showing a "younger" trend, and how should young people prevent it?

Jia Jianping: There is no data to indicate the younger trend of the disease, but the number of young people seen in outpatient clinics has indeed increased. I don't think young people can talk about prevention as a major scientific problem, because it may increase the psychological burden on young people. Young people are advised to value their memories, adopt a healthy lifestyle, and maintain a certain level of attention.

【Question 2】Does excessive brain use increase the risk of Alzheimer's disease in young people?

Jia Jianping: I don't think so. Because the brain has safety protection measures, we will feel particularly tired after using the brain excessively, that is, the brain is reminding us that it is time to rest. Moderate brain use helps protect memory and does not bring negative effects. Mental workers should pay special attention not to overwork at night, and to use the brain moderately.

Copyright statement: This article is an exclusive contribution of Tencent News "Goose Drop Doctor", and unauthorized media reproduction is prohibited.

Written by: Wang Zirui

Editor: Li Xiaodong

Source:

[1] Jia Jianping,Zhao Tan,Liu Zhaojun,Liang Yumei,Li Fangyu,Li Yan,Liu Wenying,Li Fang,Shi Shengliang,Zhou Chunkui,Yang Heyun,Liao Zhengluan,Li Yang,Zhao Huiying,Zhang Jintao,Zhang Kunnan,Kan Minchen,Yang Shanshan,Li Hao,Liu Zhongling,Ma Rong,Lv Jihui,Wang Yue,Yan Xin,Liang Furu,Yuan Xiaoling,Zhang Jinbiao,Gauthier Serge, Cummings Jeffrey. Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study. [J]. BMJ (Clinical research ed.),2023,380.