Early-onset Alzheimer’s disease with depression as the first symptom: a case report with literature review

Overview

Case Presentation

A 59-year-old female came to the hospital with the complaints of felt sadness, decreased interest, self-blame, panic, chest tightness, overall pain, loss of appetite, abdominal distention, and belching.

Physical Examination

  • Physical assessment was unremarkable.

Medical History

  • The patient had a previous history of psoriasis spanning more than 20 years.
  • Allergy to painkillers and fish.
  • She denied a history of hypertension, diabetes, cerebrovascular disease, and heart disease.
  • No history of surgery or trauma. No history of attraction or alcohol consumption.
  • Denied the history of hereditary disease, infectious disease.

Family History

  • There was no personal or family history of psychiatric illness.

Clinical Examination

  • Diagnosis ofdepression was confirmed.
  • MMSE 14 points. MOCA 12 points. PET/MRI showed brain atrophy in the bilateral hippocampus, right amygdala, bilateral frontal, temporal, occipital, and right parietal lobes.
  • DWI and SWI did not show any abnormal signals.
  • The 18F-FDG image showed decreased glucose metabolism in the right parietal lobe, bilateral partial lobe, bilateral frontal lobe, bilateral parietotemporal joint region, and bilateral partial posterior cingulate gyrus.
  • The 18F-AV45 PET image showed Aβ deposition was present in the cerebral cortex.
  • Finally, Alzheimer’s disease was diagnosed.

Treatment

  • Venlafaxine 150 mg prescribed to improve mood
  • Memantine 5 mg in the morning and 10 mg at night was added.

Clinical Outcome

During a follow-up visit 2 weeks after discharge, the patient’s family reported that the patient is doing well and increased daytime sleep.

Adapted from:

  1. Liu M, Xie X, Xie J, Tian S, Du X, Feng H, Zhang H. Early-onset Alzheimer's disease with depression as the first symptom: a case report with literature review. Front Psychiatry. 2023 Apr 27;14:1192562. doi: 10.3389/fpsyt.2023.1192562. PMID: 37181906; PMCID: PMC10174310