Expert: Mary Gordon - 12/14/2005

Question
Someone I know is 45 years of age. Alzheimer's is not a genetic disease in the family but her dad did die from it in about 1999. He was 81. She is kind of forgetful and I don't know if she could have Alzheimer's.

Answer
Kelly, as you may know "early onset" Alzheimer's is a distinct subtype of AD, and does have an extremely strong genetic component - approximately 50-50 inheritable. This is the kind that runs in families and tends to hit in middle age. It is extremely distinct - you almost always see a strong history of people getting dementia and dying young in the family.

This doesn't sound like the case here - if your friend's father got Alzheimer's in old age, he probably had the run of the mill type of AD which all of us are at risk for. The causes are not well understood and there may be a genetic component, but all of us who live into old age have relatively high odds of getting some form of progressive dementia. If you are lucky enough to make it to age 85, your odds from age alone are 50-50.

There are dozens of illnesses that cause mental confusion, cognitive impairment, memory loss - and in a 45 year old woman, this is much more likely to be what you are seeing. She needs to see a doctor. It could be a thyroid problem, depression, a side effect from a medication, pernicious anemia, a small stroke, kidney or liver problems, or any of a zillion other things. So, the first step is to make sure she isn't suffering from some physical or emotional problem that might affect her memory - especially if the "something" might be treatable - and in a 45 year old woman, that is very likely to be the case.  A good assessment includes a full physical with assorted blood tests, some psychiatric evaluation to rule out depression, a review of history and medications, a neurological work up, usually including a CAT or other brain scan to rule out strokes, tumors etc.

When I was in my early 30's, I developed hypothyroidism that wasn't diagnosed for more than a year, and I had major brain fog, and emotional issues, and they all turned out to be related to the illness. Once I got diagnosed and treated, things turned around fairly quickly and I was back to my old self.  

Memory loss is always caused by something - it is never a normal part of aging, or something we should accept without proper exploration - and 45 is not old !

Hope this helps - light a burner under her to see a doctor and get this checked out.

Mary G.
Toronto