Alzheimer's: More Evidence It Starts Long Before Adulthood

More evidence is emerging that suggests that Alzheimer’s disease begins early in life.

Researchers at Albert Einstein College of Medicine in the Bronx, NY last year said they believe the condition starts in utero and that it is a developmental disorder.

Now, in a study published July 13 online in Neurology, Linda Chang, MD of the University of Hawaii in Honolulu reports on her research on two genes known to be associated with the disease, epsilon 4 variant of the apolipoprotein-E gene.

Chang did genetic tests and brain scans on 1,187 children and young adults ages three to 20 and found that in children with the epsilon 4 gene, there were brain differences in areas of the brain that are often affected by Alzheimer’s.

Similar to elderly adults who have that gene, the subjects’ brains had smaller hippocampus volumes, on average 5% smaller than children without the gene.

Tested on their memory and thinking skills, the youngest children with the epsilon 4 gene had up to 50% lower scores on tests of executive function and working memory and some had similar slow scores on tests of attention. But by age 8 these differences in testing disappeared.

The study had many limitations, but “"Studying these genes in young children may ultimately give us early indications of who may be at risk for dementia in the future and possibly even help us develop ways to prevent the disease from occurring or to delay the start of the disease," Chang noted.

Mark Mehler, MD, a neurologist and a professor of psychiatry and behavioral sciences at Einstein believes that the condition that will later emerge as Alzheimer’s happens with gene mutations at the embryonic stem cell level, during organogenesis.

His hope is that through gene therapy, it may soon be possible to “perform gene-editing in utero,” Mehler said, to reverse the effects of the mutation. Such therapy might also result in treatments for adults in which neural stem cells could be selectively activated.