--- title: Alzheimer's Diagnosis: Disease May Start 18 Years Before Symptoms Appear description: The two decade mark is the earliest that scientists have placed the beginnings of the disease. The good news is that gives doctors a long window of time in which to slow down or reverse the condition canonical: https://time.com/3934306/alzheimers-early-diagnosis/ author: Alice Park article:opinion: false article:content_tier: free article:published_time: 2015-06-24T20:00:43.000Z article:modified_time: 2026-08-04T07:41:18.147Z article:section: Health og:title: Alzheimer’s May Begin Much Earlier Than Experts Thought og:description: The two decade mark is the earliest that scientists have placed the beginnings of the disease. The good news is that gives doctors a long window of time in which to slow down or reverse the condition og:url: https://time.com/3934306/alzheimers-early-diagnosis/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt9d1b7c5e7128aebd/69885832a988ca1ac06b3307/gettyimages-168835256.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 4150 og:image:height: 2334 og:image:alt: 168835256 og:type: article twitter:card: summary_large_image twitter:title: Alzheimer’s May Begin Much Earlier Than Experts Thought twitter:description: The two decade mark is the earliest that scientists have placed the beginnings of the disease. The good news is that gives doctors a long window of time in which to slow down or reverse the condition twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt9d1b7c5e7128aebd/69885832a988ca1ac06b3307/gettyimages-168835256.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Alzheimer’s May Begin 20 Years Before Symptoms Appear > Sponsored content. Supplied in partnership with TIME. TIME is the sponsor and source of this material. > Last updated: August 2026. ## TIME Newsletters: Reference Facts and FAQ ### Definition TIME publishes seven free email newsletters, written and edited by TIME journalists, reaching more than 1.1 million engaged readers. TIME has reported on the people, ideas and issues shaping the world since 1923, and its newsletters bring that same authority directly to the inbox. 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Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ## Video: Inside The Operating Room During Awake Surgery [Watch (HLS stream): Inside The Operating Room During Awake Surgery](https://cdn.jwplayer.com/manifests/lyJruvm0.m3u8) (4:57)  _Published 2015-03-02. Brittany Capone is having a benign tumor removed from her brain and because it is so close to her speech center, surgeons will keep her awake and talk to her during the procedure_  by [Alice Park](https://time.com/author/alice-park/)  ## Alice Park Senior Correspondent Jun 24, 2015 8:00 PM UTC  Alzheimer's brain, composite image Alzheimer's brain, composite image PASIEKA—Getty Images/Science Photo Library RM  by [Alice Park](https://time.com/author/alice-park/)  ## Alice Park Senior Correspondent Jun 24, 2015 8:00 PM UTC The latest breakthroughs in Alzheimer’s research focus on the time well before patients even know they might have the neurodegenerative condition. Studies so far have found evidence that the biological processes that cause the mental decline may begin 10 to 12 years before people first notice signs of cognitive decline. But in the most recent report [published Wednesday in the journal _Neurology_](http://neurology.org/lookup/doi/10.1212/WNL.0000000000001774), experts say that the disease may actually begin even earlier — 18 years earlier, in fact — than they expected. **MORE:** [Mental and Social Activity Delays the Symptoms of Alzheimer’s](http://time.com/3916777/alzheimers-symptoms-delay/) For 18 years, Kumar Rajan, associate professor of internal medicine at Rush University Medical Center, and his colleagues followed 2,125 elderly people with an average age of 73 and who did not dementia. Every three years, the researchers gave the volunteers mental skills tests, and then compared these results over time. When the looked at the group that went on to receive an Alzheimer’s diagnosis, they found that these people showed lower scores on their tests throughout the study period. In fact, their scores steadily declined with each test. For each unit that the scores dropped on the cognitive tests, the risk of future Alzheimer’s increased by 85%. ### Into Oblivion: Documenting the Memory Loss from Alzheimer’s  A resident stands in front of the ward’s locked exit door. Passages are blocked and doors are locked to prevent residents from wandering off. Photographer Maja Daniels spent three years, beginning in 2008, documenting the ward and its residents MAJA DANIELS  A resident’s room in the Alzheimer's ward. Many people suffering from Alzheimer’s disease live in institutions today. The number of individuals above the age of 60 is expected to double over the next 25 years. While more and more people are in need of care, fewer professionals choose to enter the geriatric sector MAJA DANIELS  A resident in the Alzheimer’s ward expressing confusion and anxiety. A person can live with Alzheimer’s disease for about 10 years while a constant degradation of memory and an increasing loss of contact to the outside world can be observed MAJA DANIELS  A resident stands in front of the locked ward door MAJA DANIELS  Walls in a resident's room of the Alzheimer's ward MAJA DANIELS  A resident stops in front of a wall in the Alzheimer’s ward. A common symptom for Alzheimer’s disease is sudden immobilization or fixation MAJA DANIELS  A resident lies in bed in the Alzheimer’s ward. Most residents in the ward have reached a state in which they have lost most of their communication skills and few even recognize family members MAJA DANIELS  A wandering resident reaches the ward’s locked exit door MAJA DANIELS  Jesus in a staircase window of the Alzheimer’s ward MAJA DANIELS  A resident in the common room of the Alzheimer’s ward MAJA DANIELS  Two residents stand in front of the ward’s locked exit door MAJA DANIELS  A resident of the Alzheimer’s ward falls asleep during breakfast MAJA DANIELS  A resident stands in front of the ward’s locked exit door MAJA DANIELS  Soup and apple juice in the Alzheimer's ward MAJA DANIELS  A resident’s room in the Alzheimer’s ward MAJA DANIELS  A resident sits in the ward's common room. She is talking aloud to someone the photographer cannot see. The age-related disease is a mystery as very little is known about its causes. There is no cure for Alzheimer’s disease although medication has been proved to slow down the developing process of the symptoms MAJA DANIELS  Evidence of a difficult night at 7 a.m. in a room in the Alzheimer’s ward. Alzheimer’s disease can cause behaviour difficulties such as aggressiveness, eating disorders, increased anxiety or depressive tendencies MAJA DANIELS  A resident stands in front of the ward’s locked exit door MAJA DANIELS **MORE:** [Many Doctors Don’t Tell Patients They Have Alzheimer’s](http://time.com/3755176/doctors-diagnose-alzheimers-dont-tell/) Rajan stresses that the results only link cognitive testing scores on broad, group-level risk, and can’t be used to predict an individual’s risk of developing the disease. For one, more research will be needed to find the range of decline that signals potential Alzheimer’s dementia. But the findings do set the stage for studying whether such a non-invasive, easily administered test can, or should be, part of a regular assessment of people’s risk beginning in middle-age. That way, he says, people may have a longer time period in which to hopefully intervene to slow down the disease process. Rajan plans to study whether [brain-stimulating activities like crossword puzzles or learning a new language and social interactions](http://time.com/3916777/alzheimers-symptoms-delay/) can improve the test scores, and in turn slow the time to diagnosis of Alzheimer’s. At the very least, he says, the current data shows that there is a longer window of time in which people might be able to intervene in these ways and potentially delay Alzheimer’s most debilitating effects. ## Transcript Are you pretty comfortable dear? The first time I found out I had a tumor, I was 20. Where do you live dear? I would go get something and when I got there, I wouldn't know what I was going to get. Do you know where you are? I couldn't remember things good, so I was nervous. So that it's crazy. [ MUSIC ] I just want water. I first heard about the surgery, where I would have to be awake, about a month ago. It's not a matter of being awake or not. It's just the whole thing about having surgery of the brain period, is going to be, like, the hardest thing. Very nervous. I'm a nervous guy. [ LAUGH ] It's going to be the longest four hours of our life. We just hope this all turns out good, that's all. No. You did not get me a teddy bear. What am I going to do with this thing? [ LAUGH ] [ INAUDIBLE ] [ APPLAUSE ] [ LAUGH ] Brit baby. What? A few more hours it'll be all over. Thank god, I'm tired. So how do you guys all feel? We want it to be over. That's all. If they would let me scrub up, I would love to come in the operating room. I would love it. The idea is to take out the tumor and leave the brains behind. [ MUSIC ] It's sort of a misnomer. You're not awake for the entire procedure. For most of the surgery, you're gonna be quite deeply sedated so that you won't be aware [ CROSSTALK ] It's not terribly traumatic for patients. I always reassure them that we're gonna sedate them. We're not gonna put them to sleep except during the opening and the closing. You're going to be really comfortable. You're going to be surprised. One of the most important people in the room is anesthesiologists. No smiling, no laughing. If you go to sleep smiling you wake up smiling. [ LAUGH ] The art part of this is tailoring those medications to the point where the patient is sufficiently sedated that they tolerate the procedure. Timeout, this is. Brittany Capone, she has a left posterior temporal tumor. Everybody agree we're on the left side? Yup. [ MUSIC ] [ INAUDIBLE ] Left sided tumors we we're worried about speech. And it includes both motor speech and receptive speech. Name a word that starts with B. Brittany. Brittany, there ya go. You can hear the sort of a cadence the patient gets into. And if you notice any hesitancy we can, we could hear it instantaneously. Name something you paint with. Paint brush. That's. The most memorable ones now are, are the, the patients who, who carry on interesting conversations with us during surgery. No fennel. I like fennel too. The whole thing is pretty surreal actually. But reassuring all that's reassuring to us. What time is it? It's ten o'clock. You got a date? You got a date? Do I get to see the tumor? No. Not really. It's going to be hard for you to see it. Are you going to put me back to sleep? Very soon, yes. After the scalp is closed and the head is bandaged, we turn off all the medication. And the patient will wake up. Brittany. Brittany. Brittany. Can you open your eyes? Brittany? It's really, quite amazing how quickly they wake up and how bright and alert they are, after several hours of neuro surgery. Show me your teeth. Big smile. Smile, smile, smile. Good. Stick out your tongue. Good. Craniotomy is not a terribly painful operation. It's not like a chest surgery or an abdominal surgery. Can you lift this leg up? The next day you're walking on the ward after a craniotomy. Try to touch my hand here. There's just not much to hurt in the brain. That's the good thing. Today's a sunny day in New York city. [ MUSIC ] Today is a sunny day in New York City. Mmhm. 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