Young-onset dementia. New insights and a case report

A diagnosis of dementia is devastating at any age but diagnosis in younger patients presents a particular challenge. Young-onset dementia (YOD) is a neurological syndrome that affects behavior and cognition of patients younger than 65 years of age. It is frequently misdiagnosed and may need a systematic approach with detailed medical history, collateral history from family members, neuropsychological testing, laboratory studies and neuroimaging, which may facilitate a more accurate diagnosis and earlier medical intervention. It is a challenging clinical problem with potentially devastating medical and social consequences. The differential diagnosis of YOD is extensive and includes early-onset forms of adult neurodegenerative conditions including Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementias, Huntington's disease, and prion disease. Late-onset forms of childhood neurodegenerative conditions may also present as YOD and include mitochondrial disorders, lysosomal storage disorders, and leukodystrophies. Potentially reversible etiologies including inflammatory disorders, infectious diseases, toxic/metabolic abnormalities, transient epileptic amnesia, obstructive sleep apnea, and normal pressure hydrocephalus also represent important differential diagnostic considerations in YOD. In this paper we aim to review the latest etiologies, and diagnostic strategies for YOD and to present a clinical case from our hospital of a young-onset dementia appeared 6 months after an ischemic stroke.