Young Onset Dementia (YOD): What is it?

Called Young Onset Dementia (YOD) or Young Onset Cognitive Impairment (YOCI), this condition typically affects 45 to 65-year-olds, though it can also hit people in their early 40s or even late 30s.

More aggressive than dementia in the old, it devastates the lives of sufferers at a time when they are still building careers and/or raising children. When hit, they find themselves coping with the diagnosis as well as the emotional and financial fallout. As it progresses, they may not be able to continue working and earning a living.

Young onset dementia (YOD) cases have been gradually increasing at the National Neuroscience Institute (NNI) in recent years. The institute sees approximately 250-300 new cases per year, and half of them are below 65 years old. With increasing awareness, the number of patients with YOD is likely to rise.

What causes Young Onset Dementia (YOD)?

According to Associate Professor Nagaendran Kandiah, Senior Consultant from the Department of Neurology at National Neuroscience Institute (NNI), and Assistant Professor, Duke-NUS Graduate Medical School Singapore, there are various reasons for the increase. One could be because of increasing awareness of young onset dementia (YOD) in recent years. Doctors are also diagnosing patients more accurately now with advanced imaging technology.

“In the past, these patients would have gone undiagnosed or been misdiagnosed with psychiatric conditions such as depression or pseudo-dementia.” Another reason could be the increasing number of younger people with diabetes, high blood pressure (hypertension) and high cholesterol. “These diseases can lead to strokes which may eventually result in vascular dementia.”

Click here to learn more about vascular dementia.

Genetics too can play a part, as about two in five patients have a parent or sibling with the condition. “Previously, when someone had symptoms of young onset dementia (YOD), the problem was usually suppressed. Now, people may notice that their symptoms are similar to those of someone else in the family, and they come forward and get tested,” said Assoc Prof Nagaendran.

Young Onset Dementia (YOD) is often caused by the same brain diseases that afflict older people but the progression of brain changes in younger people is usually more rapid, resulting in a faster loss of thinking abilities.

Also, as young people are more active socially and economically, the socio-economic impact on them is greater.

Symptoms of Young Onset Dementia (YOD)

Young onset dementia (YOD) is generally considered when cognitive and behavioural symptoms, which can vary, appear in younger individuals. Sometimes, it becomes apparent at work when patients find it difficult to plan or carry out routine tasks. Signs include: 

  • Behavioural and mood changes

  • Difficulty in abstract thinking and reasoning

  • Disoriented to time and place

  • Forgetfulness that affects day to day function

  • Forgets recently given instruction

  • Misplaces personal items

  • Neglects personal hygiene

  • Problems with language

  • Repeats questions

  • Unable to perform familiar tasks

These symptoms can worsen with stress. When this happens, family members may notice the changes in behaviour.

“The loss of language abilities can be frustrating for dementia patients and their families. Over time, they often resort to sign language; but that too, with time, is lost. However, the greater awareness of Young Onset Dementia (YOD) has resulted in more being diagnosed with early symptoms such as word-finding difficulty or usage of wrong words. Previously, these patients would receive a diagnosis only when they were nearly mute.”

How to prevent Young Onset Dementia (YOD)

Assoc Prof Nagaendran explained that early diagnosis and treatment are crucial as changes in the brain can begin 10 to 15 years before symptoms are apparent. If diagnosed early, some cases can be treated and even cured. There are already some drugs available and others are in the final phases of research.

On how to lower risk of young onset dementia, you should:

  1. Stay active by having moderate levels of physical exercise at least twice a week

  2. Have regular mental stimulation

  3. Ensure you have sufficient sleep between 7 and 9 hours

  4. Adopt a well-balanced diet that includes deep-sea fish, nuts (almonds, walnuts) and berries to slow down progression from mild cognitive impairment to dementia

Local research on Young Onset Dementia (YOD)

Ongoing genetic research has isolated several important genes associated with young onset dementia (YOD) in Caucasians. Locally, a team led by Assoc Prof Nagaendran has started a three year study of young onset dementia (YOD) among Asians, involving more than 300 patients. The first such study in South-east Asia, it is being funded by the National Medical Research Council (NMRC).

“We intend to use advanced neuroimaging techniques and conduct genetic analysis to determine the common genes in the Asian population and look out for other novel genes that could be unique to the Asian population. We will also be inviting family members to participate in the study to identify patterns of inheritance in these families,” Assoc Prof Nagaendran said.

Ref. N18

Memory Care with SingHealth Health Body

Tap the banner above to find out how Memory Care on the Health Buddy app can help you maintain or improve your memory. 

Plus, check out our other articles on dementia:

Dementia in Singapore: Fast Facts

Dementia: How to Prevent (6 Tips to Lower Your Risk)

Dementia: What You Need to Know

Dementia and Depression: Is There a Link?

Brain Diseases: Early Signs to Look Out For