The symptoms of early-onset Alzheimer’s disease doesn’t always begin with the memory changes that many people associate with dementia. For some, the first signs may involve vision, language, decision-making, behavior, or changes in daily functioning.

Dr. Gil Rabinovici, a professor of neurology and radiology at the University of California, San Francisco, and a behavioral neurologist at the UCSF Edward and Pearl Fein Memory and Aging Center, explains why Alzheimer’s can look different in people who develop symptoms before age 65. His research focuses on using brain imaging and other biomarkers to improve dementia diagnosis, better understand neurodegenerative diseases, and support the development of new treatments.

In this Live Talk with Being Patient’s founder, Deborah Kan, Rabinovici discussed how early-onset Alzheimer’s may first appear through changes in executive function, language, visual processing, or personality, and why those symptoms can sometimes lead to confusion or delayed diagnosis. He also explainsed how advances in PET scans, spinal fluid testing, and emerging blood tests are helping clinicians detect the biology of Alzheimer’s during life, while new antibody treatments and future combination therapies are beginning to reshape what diagnosis and care may look like for patients and families.

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Being Patient is an editorially independent journalism outlet for news and reporting about brain health, cognitive science, and neurodegenerative diseases. In our Live Talk series on Facebook, former Wall Street Journal Editor and founder of Being Patient, Deborah Kan, interviews brain health experts and people living with dementia.

Check out our latest Live Talks: https://beingpatient.com/live-talks/

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0:00 Intro
1:45 What defines early-onset Alzheimer’s?
5:25 How symptoms can look different in younger people
6:26 Executive function, language, vision, and behavior changes
8:52 Why diagnosis should be grounded in biology
10:14 Amyloid plaques, tau tangles, and where symptoms begin
14:10 How tau differs across Alzheimer’s, CTE, and other dementias
16:34 PET scans, spinal fluid tests, and blood tests
19:29 What blood tests like p-tau217 can show
22:29 Does younger-onset Alzheimer’s progress faster?
24:37 Physical symptoms and possible signs of other dementias
26:39 Exercise, lifestyle factors, and dementia prevention
30:40 Why early-onset Alzheimer’s diagnosis is often delayed
32:40 The importance of accurate diagnosis
35:06 What a diagnostic workup looks like today
37:10 Who may be a candidate for monoclonal antibody treatments
39:20 Why research on early-onset Alzheimer’s matters
42:23 What to watch for in tau-targeting therapies
44:04 Can people on Leqembi join the LEADS study?
45:15 Reducing stigma around Alzheimer’s diagnosis
46:19 Closing remarks