Alzheimer’s symptoms may show up much earlier than previously believed, according to a new study. Here’s what to understand.

• Symptoms of Alzheimer’s and changes in cognitive function generally emerge after age 65.

• However, a recent study in Lancet Regional Health-Americas indicates that these symptoms may occur much earlier, potentially starting in the mid-20s.

• Experts suggest that besides staying active, maintaining a healthy diet, avoiding tobacco, and reducing alcohol intake, it’s beneficial to engage your brain “vigorously” to remain sharp.

When you think of Alzheimer’s disease, it’s natural to picture an older adult. This perception aligns with the fact that symptoms typically begin to surface after age 65. Yet, emerging research points to the possibility that this debilitating disease could start affecting cognitive abilities decades before a diagnosis is made.

The notable study published in Lancet Regional Health – Americas raises critical questions about early indicators for Alzheimer’s and how to maintain cognitive health from a younger age.

Here’s a summary of the study’s findings and some insights from neurologists that might be helpful as you process this information.

What did the study find?

In their research, investigators examined data from Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health, a long-term study tracking teens since the mid-90s.

The team conducted numerous in-home interviews, cognitive assessments, and physical exams, while also collecting blood samples from many participants in their 20s and 30s. A total of 1,112 participants who underwent in-home interviews completed cognitive tasks such as immediate and delayed word recall, and backward digit spans, alongside providing genetic samples. These scores were then compared to Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) scores in 529 individuals.

The results suggested that specific risk factors and biomarkers associated with Alzheimer’s could begin to affect cognitive function as early as the mid-20s. “Key risk factors for Alzheimer’s disease are tied to cognitive function as early as ages 24–44, emphasizing the importance of early prevention in the US,” the researchers concluded.

What types of biomarkers did the study reveal?

The study looked at various factors, particularly the CAIDE score, which considered aspects such as age, education, sex, systolic blood pressure, body mass index, cholesterol, physical activity, and the apolipoprotein E ε4 allele (APOE ε4), a known genetic risk factor for Alzheimer’s.

Researchers also identified ATN (amyloid, tau, neurodegeneration) and immune biomarkers related to Alzheimer’s that might exist and affect cognitive function in people under 40.

Is there a testing method to assess my risk?

Partially. “When younger patients express concerns about potential dementia in later years, I ‘risk stratify’ them and perform similar tests I would for older patients worried about the same issues,” says Clifford Segil, DO, a neurologist in Santa Monica, CA.

This entails conducting blood tests to identify reversible causes of memory issues—such as thyroid function and vitamin B12 levels. “I might also obtain structural imaging to check for silent strokes or atrophy,” Dr. Segil adds.

For younger individuals, the only available “test” for Alzheimer’s risk might involve checking APOE 4 levels, which is regarded as the most significant genetic risk factor. “However, finding a positive result in a young individual is complex to interpret in terms of clinical significance,” he explains.

What can I do to safeguard my brain health before turning 30?

Several factors can help you promote brain health as you age. In addition to eating a balanced diet, remaining active, avoiding tobacco, and moderating alcohol intake, actively engaging your brain is essential, according to Amit Sachdev, MD, MS, medical director of the Neurology Department at Michigan State University.

“Investing in education, along with social interactions, can significantly enhance mental agility. Seeking out new friendships and interests in youth contributes to developing lasting relationships that are important later in life,” he suggests.

Additionally, Dr. Segil advises keeping both body and mind occupied to support cognitive health.

Ultimately, if you’re worried about dementia risk or have a family history of the illness, it might be wise to consult your primary care physician for tailored advice.

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