Clinical characteristics of early-onset Alzheimer's disease in Peru: a case series from a neurology center

Sheila  Castro-Suarez; Jonathan A. Zegarra-Valdivia; María  Meza-Vega; Erik A. Guevara-Silva

doi:10.17843/rpmesp.2025.422.14413

Authors

Sheila Castro-Suarez Centro Básico de Investigación en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Perú. Global Brain Health Institute, San Francisco , California, Estados Unidos https://orcid.org/0000-0003-0313-3987
Jonathan A. Zegarra-Valdivia Universidad Señor de Sipán, Chiclayo, Perú https://orcid.org/0000-0003-0497-5270
María Meza-Vega Centro Básico de Investigación en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Perú. Universidad Nacional Mayor de San Marcos, Lima, Perú https://orcid.org/0000-0003-4166-6944
Erik A. Guevara-Silva Centro Básico de Investigación en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Perú. https://orcid.org/0000-0002-1106-5024

DOI:

https://doi.org/10.17843/rpmesp.2025.422.14413

Keywords:

Alzheimer Disease, Alzheimer Type Dementia, Dementia, Early Onset, Neurocognitive Disorders

Abstract

Early-onset Alzheimer’s disease (EOAD) accounts for between 5 and 10% of all cases of Alzheimer’s disease and is a rare and devastating form of the disease. This retrospective study analyzed the medical records of patients diagnosed with EOAD between 2022 and 2023 at a tertiary neurological center in Lima, Peru. Of 547 cases of dementia, 60 met the criteria for EOAD. Most were women (73.3%), and 71% had more than six years of education. The mean MMSE score was 11.92 ± 7.5, and the mean CDR score was 2, indicating severe cognitive impairment and moderate dementia. The amnestic variant was the most common clinical form, highlighting the involvement of episodic memory and executive function. The most common psychological and behavioral symptoms were depression and irritability. Atypical features such as myoclonus (5%) and epilepsy (10%) were also identified. These findings highlight the importance of healthcare professionals recognizing dementia in young adults at an early stage and offering comprehensive management to improve the quality of life of patients and their families.

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References

Jack CR, Andrews JS, Beach TG, Buracchio T, Dunn B, Graf A, et al. Revised criteria for diagnosis and staging of Alzheimer’s disease:

Alzheimer’s Association Workgroup. Alzheimers Dement. 2024;20(8):5143–69. doi: 10.1002/alz.13859.

Valdez-Gaxiola CA, Rosales-Leycegui F, Gaxiola-Rubio A, Moreno-Ortiz JM, Figuera LE. Early- and Late-Onset Alzheimer’s Disease: Two Sides of the Same Coin? Diseases. 2024;12(6):110. doi: 10.3390/diseases12060110.

Sirkis DW, Bonham LW, Johnson TP, La Joie R, Yokoyama JS. Dissecting the clinical heterogeneity of early-onset Alzheimer’s disease. Mol Psychiatry. 2022;27(6):2674–88. doi: 10.1038/s41380-022-01531-9.

Kovalenko EA, Makhnovich EV, Bogolepova AN, Osinovskaya NA, Beregov MM. [Features of the clinical and neuroimaging picture in patients with early-onset Alzheimer’s disease]. Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(4. Vyp. 2):56–63. doi: 10.17116/jnevro202412404256.

Tellechea P, Pujol N, Esteve-Belloch P, Echeveste B, García-Eulate MR, Arbizu J, et al. Early- and late-onset Alzheimer disease: Are they the same entity? Neurologia (Engl Ed). 2018;33(4):244–53. doi: 10.1016/j.nrl.2015.08.002.

Altomari N, Bruno F, Laganà V, Smirne N, Colao R, Curcio S, et al. A Comparison of Behavioral and Psychological Symptoms of Dementia (BPSD) and BPSD Sub-Syndromes in Early-Onset and Late-Onset Alzheimer’s Disease. J Alzheimers Dis. 2022;85(2):691–9. doi: 10.3233/JAD-215061. 7. https://www.incn.gob.pe/estadistica/.

McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR, Kawas CH, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s and Dementia. 2011;7(3). doi: 10.1016/j.jalz.2011.03.005.

Crutch SJ, Schott JM, Rabinovici GD, Murray M, Snowden JS, van der Flier WM, et al. Consensus classification of posterior cortical atrophy. Alzheimers Dement. 2017;13(8):870–84. doi: 10.1016/j.jalz.2017.01.014.

Gorno-Tempini ML, Hillis AE, Weintraub S, Kertesz A, Mendez M, Cappa SF, et al. Classification of primary progressive aphasia and its variants. Neurology. 2011;76(11):1006–14. doi: 10.1212/WNL.0b013e31821103e6.

Ossenkoppele R, Singleton EH, Groot C, Dijkstra AA, Eikelboom WS, Seeley WW, et al. Research Criteria for the Behavioral Variant of

Alzheimer Disease: A Systematic Review and Meta-analysis. JAMA Neurol. 2022;79(1):48–60. doi: 10.1001/jamaneurol.2021.4417.

Custodio N, Lira D. Adaptación peruana del Minimental State Examination (MMSE). Anales de la Facultad de Medicina. 2014;75(1):69–69.

Morris JC. The clinical dementia rating (cdr): Current version and scoring rules. Neurology. 1993;43(11):2412–4. doi: 10.1212/wnl.43.11.2412-a.

Apostolova LG, Aisen P, Eloyan A, Fagan A, Fargo KN, Foroud T, et al. The Longitudinal Early-onset Alzheimer’s Disease Study (LEADS):

Framework and methodology. Alzheimers Dement. 2021;17(12):2043–55. doi: 10.1002/alz.12350.

Custodio N, Montesinos R, Chambergo-Michilot D, Herrera-Perez E, Pintado-Caipa M, Seminario G W, Cuenca J, Mesía L, Failoc-Rojas VE, Diaz MM. A Functional Assessment Tool to Distinguish Controls From Alzheimer’s Disease in Lima, Peru. Am J Alzheimers Dis Other Demen. 2022;37:15333175221104354. doi: 10.1177/15333175221104354.

Clark CM, DeCarli C, Mungas D, Chui HI, Higdon R, Nuñez J, et al. Earlier onset of Alzheimer disease symptoms in latino individuals

compared with anglo individuals. Arch Neurol. 2005;62(5):774–8. doi: 10.1001/archneur.62.5.774.

Illanes-Manrique M, Giron-Davila P, Silva-Bullon M, Adams L, Castro-Suarez S, Rios-Pinto J, et al. Social Determinants of Health in

Alzheimer’s Disease Patients from Peru, Nested Study From the Peruvian Alzheimer Disease Initiative (PeADI) (P11-3.005). Neurology. 2025; 104 (7_Supplement_1). doi: 10.1212/WNL.0000000000212310.

Echeveste B, Tellechea P, Montoya G, Espinoza-Vinces C, Fernandez-Montero A, Riverol M. [Neuropsychological differences in

Alzheimer’s disease depending on the age of onset]. Rev Esp Geriatr Gerontol. 2024;59(1):101433. doi: 10.1016/j.regg.2023.101433.

Fang S, Zhang S, Wang W, Li Y, Zhang X, Yu H, et al. Behavioural and psychological symptoms of early-onset and late-onset Alzheimer’s disease among Chinese adults: analysis of modifiable factors. Psychogeriatrics. 2022;22(3):391–401. doi: 10.1111/psyg.12829.

Contador J, 20. Pérez-Millan A, Guillén N, Sarto J, Tort-Merino A, Balasa M, et al. Sex differences in early-onset Alzheimer’s disease. Eur

J Neurol. 2022;29(12):3623–32. doi: 10.1111/ene.15531.

Kovalenko EA, Makhnovich EV, Bogolepova AN, Osinovskaya NA, Beregov MM. [Features of the clinical and neuroimaging picture in patients with early-onset Alzheimer’s disease]. Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(4. Vyp. 2):56–63. doi: 10.17116/jnevro202412404256.

Diaz MM, Custodio N, Montesinos R, Lira D, Herrera-Perez E, Pintado-Caipa M, et al. Thyroid Dysfunction, Vitamin B12, and Folic

Acid Deficiencies Are Not Associated with Cognitive Impairment in Older Adults in Lima, Peru. Front Public Health. 2021;9:676518. doi:

3389/fpubh.2021.676518.