Young-onset dementia — structured clinical viva

Define YOD as dementia with onset before 65 years; cite global prevalence context (~119/100,000 aged 30–64) and that differentials reweight toward EOAD, FTD, vascular, alcohol-related, and treatable/genetic rarities.^[1][2]

This pedigree-rich amnestic-executive presentation favours familial EOAD; name APP, PSEN1, PSEN2 and insist on genetic counselling before testing.^[3][4][8] Still exclude FTD and other mimics with phenotype, MRI, and selective biomarkers.^[9][10]

If AD is confirmed, offer donepezil 5 mg oral daily → 10 mg after 4 weeks if tolerated with cholinergic monitoring.^[5] Antipsychotics only for severe risk BPSD; cite mortality increase from meta-analysis.^[6] Capacity is decision-specific (Appelbaum); address driving and employment as core medical issues.^[7]