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Depression and Vertigo Appeared More Often in Medical Records Before Early Alzheimer’s Diagnoses, a Study Finds
Guest Contributor
When most people think of Alzheimer’s disease, they picture memory loss that appears later in life. Yet a growing body of research suggests the story is more complicated, especially for early-onset Alzheimer’s, which affects people under 65. A new analysis from Finland highlights a series of surprising warning signs that may appear up to 15 years before an early-onset Alzheimer’s diagnosis, raising important questions about how we understand brain health and the earliest phases of this condition.
This study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, examined the medical records of 407 people with early-onset Alzheimer’s disease and compared them to more than 4,000 individuals without progressive neurodegenerative disease. Researchers focused specifically on the 15 years leading up to an Alzheimer’s diagnosis. What stood out was how often those who eventually developed early-onset Alzheimer’s had sought care for a range of seemingly unrelated health issues compared with the general population.
These early health issues became especially common in the five years just before diagnosis. Vertigo appeared in 5.9% of patients with early-onset Alzheimer’s compared with 2.1% of people in the comparison group. Depression was documented in 5.7% of those later diagnosed with early-onset Alzheimer’s compared with 2.3% in others. Headaches, delirium, brain injuries, thyroid disorders, alcohol-related disorders, epilepsy, and stroke also appeared more frequently in the group that went on to develop early-onset Alzheimer’s.
The pattern extended beyond neurological and mental health symptoms. People who eventually received an early-onset Alzheimer’s diagnosis were more likely to have ear, nose, and throat diseases within one to five years before their condition was identified. Overall, interactions with the healthcare system climbed sharply in the year before diagnosis, suggesting that patients and clinicians were searching for answers to a cluster of problems that did not yet look like classic Alzheimer’s disease.
One detail the research team found particularly interesting was what did not differ. Conditions that are strongly associated with late-onset Alzheimer’s, such as high blood pressure and high cholesterol, did not appear more frequently in the early-onset group than in the general population. In other words, the usual cardiovascular risk factors that raise concern for dementia in older adults did not show the same pattern in this younger group.
Experts involved in the work emphasize that the findings highlight association rather than cause. The study cannot say whether problems like vertigo, depression, or thyroid disorders actually contribute to early-onset Alzheimer’s or whether they emerge as part of the brain changes that are already underway. Suvi-Johanna Krüger, M.D., Ph.D., a clinical lecturer and study co-author, notes that neuropathological changes in Alzheimer’s are believed to begin 15 to 20 years before cognitive symptoms are obvious. Some of the conditions identified in the research may be early expressions of that gradual brain shift. Others may simply share underlying biological pathways with dementia or reflect broader health vulnerabilities.
Raymond Romano, Ph.D., M.P.H., a dementia researcher and family nurse practitioner, explains that early changes in the brain can affect mood, sleep, balance, and other neurologic functions long before memory problems stand out. In that context, it makes sense that a person might seek care for dizziness, depression, or unexplained headaches years before anyone suspects an evolving neurodegenerative disease. The symptoms may not look like a memory disorder at first, yet they can still be connected to brain health.
Other experts are more cautious about drawing direct lines from these early symptoms to early-onset Alzheimer’s. Neurologist Clifford Segil, D.O., points out that there is no clear neurological reason why such a wide variety of conditions would all be caused by early-onset Alzheimer’s itself. It might simply be that individuals who experience numerous health difficulties are monitored more closely, which could lead to an earlier recognition of cognitive concerns and a faster path to diagnosis.
I found this debate striking, because it underscores a central challenge: many of the conditions identified in the study are common and usually have nothing to do with dementia. Headaches, vertigo, mood changes, and respiratory or thyroid issues show up in countless medical visits every year. The new findings are not meant to suggest that anyone with these symptoms is on a path to early-onset Alzheimer’s. Instead, they introduce the idea that patterns of multiple, persistent, or unusual symptoms might, in some people, hint at changes in brain health that deserve attention.
Clinicians quoted in connection with the study are clear on this point. Someone who develops a runny nose, breathing problems, or a thyroid disorder should see a primary care clinician, because these conditions are generally treatable and manageable on their own. A person with new or worsening memory loss before age 65, on the other hand, should see a neurologist for a formal evaluation for dementia and other cognitive disorders. The goal is not to spark alarm in everyone with common ailments, but to encourage careful evaluation when memory and thinking changes are present alongside other health concerns.
The researchers and experts also highlight a broader message: brain health and overall health are deeply interconnected. Romano notes that taking care of cardiovascular health, mental health, sleep, hearing, and alcohol use supports the brain whether or not someone is at elevated risk for dementia. Even though the Finnish study did not find strong ties between traditional cardiovascular risk factors and early-onset Alzheimer’s, decades of research support heart-brain connections for later-onset disease and for long-term cognitive resilience in general.
For individuals and families, the practical takeaway is to pay attention to persistent changes. If someone experiences ongoing mood shifts, balance problems, or repeated episodes of confusion, especially when combined with classic signs of cognitive decline such as memory problems, trouble performing at work, or language difficulties, it is worth bringing the full picture to a healthcare provider. Early-onset Alzheimer’s may be relatively rare, but early evaluation can open doors to treatment options, support services, and time for planning that might otherwise be lost.
Krüger emphasizes the importance of early diagnosis for exactly these reasons. Identifying the disease in its initial stages allows patients and their families to connect with resources, discuss future care preferences, and access therapies while they may still have the greatest impact. Further research will need to unravel which early symptoms truly belong to the prodromal phase of early-onset Alzheimer’s, which are shared risk factors, and which are simply parallel health issues. For now, the study reinforces a simple yet powerful principle: caring for the whole body is an investment in the brain, and persistent or puzzling health changes deserve to be taken seriously, especially when they touch memory and thinking.