AD has been classified into two categories: early onset Alzheimer’s disease (EOAD) and late onset Alzheimer’s disease (LOAD). AD that appears before the age of 65 is known as EOAD [6,7] 5 to 10 % of AD cases are EOAD cases, although 10-15 % of these cases have recognized mutations in the APP (Amyloid precursor protein), PSEN1, and PSEN2, which are associated with EOAD [8].

Previous studies have reported Alcohol is significance as a risk factor and contribution to AD related cognitive deterioration [9]. It has been reported that Cigarettes' nicotine and other chemicals can harm blood vessels, reducing blood flow to the brain and impairing its ability to operate. Conditions like Alzheimer's may arise as a result of this. Furthermore, smoking increases oxidative stress and inflammation [10]. Recently a case control study is being done on 59-year-old woman was diagnosed with depression at the age of 50 At the age of 53, she began to exhibit cognitive dysfunction, which included memory loss and disorientation, and she eventually developed dementia [11].

CASE REPORT

A 57-Year-old male patient, weight-70 Kg, BP 81/118 resident of rural Kullu, the patient came to OPD of Neurology department, IGMC& Hospital Shimla Himachal Pradesh with 12-month history of memory loss, trouble pronouncing words, and notable changes in his capacity to carry out everyday duties, such as handling money and planning tasks at home. He was also observed to be more socially isolated and irritable. On neurological examination by the physicians, the patient was found to have cerebellar atrophy, MMSE score was 16/30, blurring of vision, the patient came with the history of depression from last 2 years no hypertension, no head injury. Patient was use to tobacco, opium the patient was alcoholic, non- vegetarian patients was married at 17 years of his age with 2 kids. patient was prescribed on Memantine hydrochloride and Donepezil hydrochloride 5 mg & also on multivitamins.

MRI report shows multiple punctate signal intensity are seen in bilateral frontoparietal subcortical white matter showing hyper intense signal on T2W and FLAIR images suggestive of chronic microangiopathic changes, bilateral ventricle and sulci are prominent-suggestive of cerebral atrophy.

RESULT

The result of this study demonstrated that all three interleukins were elevated and Vit B12 & vit D reported deficient in this case report patient.

DISCUSSION

In this case report we found levels of IL-6, TNF, and IL-1β elevated in patients with EOAD and their possible contribution to the illness according to our findings, EOAD patients had noticeably higher levels of these pro-inflammatory cytokines than age-matched controls. Our study was similar to Dursun E [11] found IL-6 & IL 1β elevated in EOAD patient’s serum. Our research indicates that these cytokines are essential for amplifying neurodegeneration and accelerating the course of EOAD. Targeting these cytokines with particular inhibitors may provide novel therapeutic options for controlling EOAD, and clinically, they may function as biomarkers for early diagnosis and disease monitoring. These findings are compared with previous research they also found that IL-1β values were higher in people with AD, Chen R [12] and KIM YS [13] also found elevated TNFα in AD patients. [12,13].

CONCLUSION