B - 125 Atypical Alzheimer’s Disease in a Highly Educated Individual: a Case Study

Abstract Objective Early onset of atypical Alzheimer’s disease (ad) can be challenging to identify, especially in highly educated individuals. Protein deposits in neural areas other than the medial temporal lobe can be associated with a heterogeneous neurocognitive pattern. We present a case that highlights the value of biomarker studies in these individuals. Method A 67-year-old, right-handed female with 18 years of education presented with inefficient word retrieval and mental set loss, which emerged approximately two to three years prior. Symptoms worsened in the context of gabapentin use status post lung cancer resection without return to baseline with steady progression. Remaining medical history includes a 1.4 cm right parietal falcine meningioma, hyperlipidemia, and depression. Results In the context of high average premorbid functioning, challenges included complex executive functioning, subtle visuospatial deficits, and encoding and recall inefficiencies. Naming was low average. Neuroimaging revealed mild parietal and dorsal frontal atrophy, potentially age-appropriate, with no significant hippocampal atrophy. Conclusions The present case highlights the possibility of atypical protein deposits and neurocognitive pattern in a highly educated individual with the potential of an early onset ad process. The value of biomarkers and neuropsychological nuances will be of increasing relevance in the context of emerging amyloid therapies.