When does Alzheimer’s start? Brain changes before symptoms

A recent article stopped me in my tracks. It described a small number of people who received a particular growth hormone treatment as children and developed cognitive symptoms some 30 to 40 years later. Researchers are investigating whether amyloid proteins in that historical treatment could have helped trigger the changes later found in their brains.

These are exceptionally rare cases. Alzheimer’s is not contagious, and the findings don’t mean that everyone has a 30-year countdown before symptoms appear.

What stayed with me was the length of that gap. We tend to think of Alzheimer’s beginning when someone starts forgetting appointments, losing words or struggling with familiar tasks. But by the time those changes become noticeable, something may have been happening in the brain for many years. Research in other groups has also detected biological changes long before memory difficulties appear.

For me, that changes the question. Instead of asking only, “What can we do once memory problems start?”, we can also ask, “How can we support brain health while we still feel well?”

At CogMission, that means looking at the whole person. Blood pressure, blood sugar, cholesterol, movement, hearing and social connection all deserve attention. We can explore someone’s health history, notice patterns over time and work out which changes are both meaningful and realistic for them.

This isn’t about promising that dementia can always be prevented. We do know that more than half of cases of dementia be prevented. And nobody should feel they have failed if they develop it. It’s about recognising that brain health is built across a lifetime. We don’t have to wait for a memory complaint to start caring for it.