‘Still Alice’ movie portrays young onset dementia

"An Academy Award for this movie would be a triumph," says Brian Appleby, MD, geriatric psychiatrist at University Hospitals Case Medical Center about the movie, "Still Alice," starring Julianne Moore. She won Best Actress Oscar for her portrayal of a Harvard University professor with early or young onset dementia.

"It's very accurate," says Dr. Appleby, although he stresses everyone's experience with the disease is different. About 5 percent of the 5 million Alzheimer's cases in the U.S. are young onset, defined as occurring before the age of 65, and Dr. Appleby says it's different than Alzheimer's in older patients.

"I'm so happy and thrilled actually to be actually be able to shine a light on Alzheimer's disease," said Moore in her Oscar acceptance speech. "People with Alzheimer's deserve to be seen so that we can find a cure."

Since the condition is relatively unexpected, it's more difficult to accurately diagnose young onset Alzheimer's, which usually occurs two to three years after the initial symptoms in most cases. Plus, since patients are younger, the brain can compensate and disguise the disease, as Moore's character did in the movie by leaving notes for herself. In addition to short term memory loss, young onset Alzheimer patients also can experience problems with spatial relationship and with calculations, like having trouble with spreadsheets and checkbooks. The disease in younger people can also manifest itself with psychological signs like mood shifts, increased irritability, and depression, which friends and family can confuse with a midlife crisis or the change of life.

Early diagnosis can help families with finances and apply for disability earlier but there is no cure, only the ability to slow the progression of the disease. "There are a lot of triumphs despite this horrible illness," says Dr. Appleby. "It's something that they're living with, it's not a terminal illness, it's not a death sentence and they're living a very full life, albeit different than before they were affected, but they still very much are themselves."

Signs of Young Onset Alzheimer's
*Short-term memory loss
*Difficulty with spatial relationships
*Difficulty with calculations
*Mood changes, depression, irritability

Family members can observe these changes many times before the patient