Doctors warn of early dementia

China is recording a sharp increase in young-onset dementia rates, with new research showing its growth now outpaces that of late-onset dementia, a shift doctors say is increasingly visible in clinics and adds urgency to earlier detection.

A study published in The Journal of Prevention of Alzheimer's Disease in early November, using Global Burden of Disease data from 1990 to 2021, found that dementia beginning before age 65 in China has been increasing significantly faster than cases in older adults. The trend is linked to modifiable midlife risk factors such as tobacco use, high fasting plasma glucose and high body mass index.

The findings mirror what neurologists report on the ground. At Xuanwu Hospital in Beijing, Qin Qi, an associate chief physician, said more of her dementia patients are now in their 50s and early 60s, many still employed when symptoms begin disrupting work and family life.

Based on the age of onset, dementia is typically classified into young-onset dementia, or YOD, occurring before 65, and late-onset dementia, or LOD, occurring at or after age 65.

But unlike late-onset dementia, young-onset cases often show atypical symptoms such as executive dysfunction, language deficits or neuropsychiatric features such as hallucinations and delusions, rather than early memory loss. "These signs are easily mistaken for stress or anxiety," Qin said, leading to frequent misdiagnosis and delayed treatment.

Qin described one patient, a highly educated lawyer, who gradually became irritable and withdrawn. For a long period he was treated as having a psychiatric disorder.

"Only when he began repeatedly losing track of names, dates and basic daily routines was he referred to us," she said. Imaging eventually confirmed his YOD.

For patients' families, the impact is profound. Zhu Yining, who cares for his mother diagnosed in her 50s, said early signs included a decline in handwriting and repetitive storytelling. Later came symptoms such as disorientation to time and place, difficulty managing daily tasks and loss of calculation and writing skills.

Zhu has paused his career to care for his mother and his young son.

He has been learning about the disease, connecting with the caregiver communities and planning for the long run. "For the families, it's crucial to make mental and practical preparations in advance," he said. "That's what the doctors advised."

According to data from the National Health Commission released in September 2022, China has about 15 million dementia patients aged 60 and above, including 10 million with Alzheimer's disease, underscoring the scale of the challenge as cases continue to rise with age.

Early detection is widely regarded as a fundamental step in managing Alzheimer's in the current world.

The 2024 Lancet Commission report on dementia prevention showed that around 45 percent of dementia cases could be preventable by reducing 14 risk factors including hypertension, diabetes, obesity, smoking, depression and social isolation.

Qin said midlife prevention and timely recognition remain crucial. "Early diagnosis creates opportunities for more effective intervention," she said.

In early 2025, China rolled out a national action plan on dementia, setting targets for 2030 to expand cognitive screening, strengthen early diagnosis and intervention, improve care services and build a more dementia-friendly environment.