Early-onset Alzheimer's led Canadian influencer to assisted death

With her rapid cognitive decline, Rebecca decided to undergo an assisted dying procedure, authorized in Canada. She died last Saturday (25), aged 49.

The case drew attention to a type of Alzheimer's that tends to bring additional challenges precisely because it affects people still of working age and can manifest itself in different ways than those seen in the elderly.

An important aspect is that memory loss is not always the first symptom.

"While the disease most commonly begins with memory failures, in early-onset forms it can present with changes in language, behavior or even vision, because other areas of the brain can be affected before memory," says neurologist Carlos Uribe, from Hospital Brasília, part of Rede Américas.

This characteristic helps explain why many patients spend months or even years looking for other explanations for their symptoms.

In younger people, doctors and patients tend to associate cognitive difficulties with overwork, stress, anxiety or psychiatric disorders.

Before thinking about a neurodegenerative disease, it is necessary to rule out other conditions that can also cause cognitive changes, such as depression, brain tumors, bleeding and other potentially reversible diseases.

"What draws attention is the persistence of complaints and the impact they begin to have on everyday life. When this happens, it is worth carrying out a specialized assessment", says Uribe.

Gerontologist Claudia Alves, specialist in people with dementia and creator of the @obomdoalzeimer profile on Instagram, states that brain changes begin many years before symptoms become evident.

"When symptoms such as loss of recent memory, disorientation in time and space and mood changes appear, many people believe that they are at the beginning of Alzheimer's because they have just received the diagnosis. But the disease may have been developing for five, six, seven or even ten years", he says.

Alves says that family members play an important role in identifying the first changes.

"The family needs to pay attention when a person starts to behave differently than their standard. This often ends up being treated as 'an age thing', but getting older does not mean completely changing behavior", he says.

Although hereditary cases exist, they are considered rare. According to Uribe, some families have genetic mutations that practically determine the development of the disease, generally between 40 and 50 years of age.

For most people, however, the diagnosis depends on clinical assessment and, when necessary, specific tests capable of identifying biomarkers of the disease.

"Genetic investigation is indicated mainly when there are several cases in the family and they begin at a very young age. In cases that arise after the age of 65, this genetic cause is much less frequent", he states.

Uribe says that these tests have gained importance because, for the first time, there are medications capable of modifying the progression of Alzheimer's in selected patients.

"Today there are treatments that can change the course of the disease. They do not yet represent a cure, but they are an important first step. The benefit is greater precisely when the diagnosis occurs in the early stages, because there is a therapeutic window", he says.

LIFESTYLE AND PREVENTION

While treatment is not yet able to stop the progression of the disease, lifestyle changes continue to be one of the main strategies to preserve autonomy for longer.

Alves defends five measures with greater scientific support: balanced diet, quality sleep, regular physical activity, cognitive stimulation and maintenance of social life.

"These habits help protect the brain throughout life and can also help people who already have cognitive decline to preserve their autonomy for longer", he says;

She also emphasizes that the diagnosis should not lead to the isolation of the patient.

"Family and friends need to know the disease to know how to deal with it. The person should not be excluded from activities or treated like a child. They continue to understand a lot and should participate in social life within their possibilities", he says.