Dementia is more common as people grow older, but it can develop at a younger age. According to recent research from Australia, younger sufferers experience faster progression and need support that’s different from their elderly counterparts.
Since they are more likely to have atypical symptoms and less likely to report memory loss, even getting a diagnosis can be more challenging for younger people, says Monica Cations, a clinical psychologist and researcher at Flinders University in Adelaide.
“They may experience changes to their personality or behaviour, such as suddenly becoming more irritable,” she says. “Language changes are not uncommon – difficulty finding words or knowing the names of things. And problems with executive function can be early signs: trouble planning or making decisions, and thinking through the consequences of things.”
There are limited tools for early dementia detection and, with younger sufferers, it can often be put down to other factors such as depression or work stress. “But then they will change their work environment and it won’t go away,” says Cations.
Younger people may have less-understood types of the condition, which can make it even harder to identify what’s going on. And, once they do get a diagnosis, they face different challenges. For instance, they may still be at a life stage when they have young children at home, are supporting a household with a mortgage and have elderly parents to care for.
“Every patient has a different symptom profile and comes to their dementia with a unique life, so what is needed to stay independent and keep functioning will vary from person to person,” says Cations.
“But there are things everyone can do to live well after a diagnosis, such as staying socially engaged, exercising, having good nutrition and doing occupational therapy.”
Young-onset dementia is defined as symptoms in people under the age of 65, and about 5% of sufferers fall into this category. Cations is now looking at how services can better meet the needs of these patients so they can remain independent for as long as possible. She aims to develop and test some programmes.
“People with mild to moderate impairment can live at home doing quite well,” she says. “But they need a scaffolding of support around them, so they can access services when they require them, and that doesn’t really exist currently. We’re interested to see if we can provide the kind of scaffolding that will help people be the guiders of their own care.”
A study of 5400 people with young-onset dementia by the Australian Institute of Health and Welfare found 58% required permanent residential aged care. A quarter were aged under 65 at the time of entry to care.
“Most young people with dementia don’t want to live in a facility surrounded by people who are much older than them, so it’s a challenge to find the right kind of housing,” says Cations.
She has been working in the dementia field for 15 years and says the most common question she is asked is how to tell whether something is a natural part of getting older or the sign of a problem.
“What I usually say is that people with dementia experience quite significant impairments, things that are unusual and out of character for them, such as getting lost on a route they have taken many times before. Also, these changes get worse over time.”
Cations also stresses that a healthy lifestyle can do a lot to reduce the chances of developing dementia. “Managing alcohol intake is a huge one,” she says. “Most people who have a dementia that is directly caused by alcohol are quite young and developed those changes in their 40s and 50s.”
There is evidence that not smoking, looking after heart health, avoiding head injuries and hearing loss and staying mentally engaged and connected can lower the risk. Exercising and eating a Mediterranean diet can help delay its onset, probably because both reduce inflammation. Conversely, science suggests that chronic stress can lead to neurodegeneration.
“There is a lot of attention on genetics, but in most cases, potentially modifiable factors can have more of an impact on our risk than genes do. That’s true for younger and older people with dementia.”
This article was originally published August 20 2022
