Early signs of dementia in men
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Early Signs of Dementia in Men
Genetic Markers and Early-Onset Alzheimer's Disease
HLA-A2 Antigen
Research has identified the HLA-A2 antigen as a potential marker for early-onset Alzheimer's disease (EOAD) in men. A study found that 100% of men with EOAD had the HLA-A2 antigen, a significantly higher frequency compared to cognitively intact men of similar age (30%) and other patient subgroups, including late-onset men and women . This suggests that HLA-A2 positive men may have an increased susceptibility to early-onset dementia.
Behavioral and Cognitive Symptoms
Mild Behavioral Impairment (MBI)
Mild behavioral impairment (MBI) has been recognized as an early sign and predictor of Alzheimer's disease dementia. MBI includes psychiatric and behavioral disturbances that occur before the onset of typical cognitive symptoms. These disturbances are linked to early Alzheimer's pathologies, such as amyloid-beta and tau protein accumulations . Early intervention for MBI could potentially alleviate long-term cognitive decline.
Memory Complaints and IADL-Restriction
Subjective memory complaints (SMC) and restrictions in instrumental activities of daily living (IADL) are early symptoms observed in the prodromal phase of dementia. In men, IADL-restriction is significantly associated with an increased risk of dementia, particularly within the first five years of symptom onset. Conversely, SMC is not a significant predictor in men but is in women . This indicates that men may report difficulties later in the disease process, primarily through IADL-restriction.
Cognitive and Neurological Symptoms
Depression and Cognitive Impairment
Depression and cognitive impairment are among the first symptoms to appear in individuals who are later diagnosed with Alzheimer's disease. In early-onset Alzheimer's disease, cognitive impairment is more prevalent, while depression is less common compared to late-onset Alzheimer's disease . Memory loss is a prominent early symptom, often presenting years before a clinical diagnosis.
Non-Memory Presentations
In early-onset Alzheimer's disease, non-memory symptoms such as apraxia (difficulty with motor planning), language problems, and executive dysfunction are more common compared to late-onset Alzheimer's disease. These non-memory symptoms can sometimes lead to misdiagnosis, as they are less typical presentations of Alzheimer's disease .
Risk Factors in Adolescence
Lifestyle and Health Factors
A nationwide cohort study identified several risk factors in late adolescence that are associated with young-onset dementia (YOD) in men. These include alcohol intoxication, stroke, use of antipsychotics, depression, a family history of dementia, drug intoxication, low cognitive function, low height, and high systolic blood pressure. These factors are multiplicative and most are potentially modifiable, suggesting opportunities for early prevention .
Conclusion
Early signs of dementia in men can be diverse, ranging from genetic markers like the HLA-A2 antigen to behavioral changes such as mild behavioral impairment and IADL-restriction. Cognitive and neurological symptoms, including depression and non-memory presentations, are also critical early indicators. Identifying and addressing risk factors from adolescence can provide significant opportunities for early intervention and prevention of dementia in men.
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