James Smith remembers the utter shock of hearing his diagnosis.
"I'm 45 years old, you know?" he recalls. "I can't have Alzheimer's."
But his doctor explained it is not uncommon. The Alzheimer's Association says it's an emerging phenomenon — as many as 650,000 Americans under age 65 have now been diagnosed with the disease.
For James' wife Juanita there was also profound disbelief.
"We've talked about, you know, why wasn't it cancer?" she says.
Experts say the incidence of Alzheimer's is not increasing in younger people. Rather, doctors are better at diagnosing it and there is less of a stigma attached to the disease.
James was the first tonotice a problem — at the office. He was director of information technology for a giant corporation, supervising hundreds.
"It's one thing to forget details of like, a project you might be working on," he says. "But it's another thing to forget the project exists entirely."
Now no longer working, James says the days that scare him most are those when he doesn't worry.
"The days when I think everything seems to be going fine are the days when I'll leave the stove on," he says. "I'll put, you know, my tennis shoes in the refrigerator."
With their two daughters at college, James and Juanita's life is now consumed with reminders to overcome his failing memory — notes to do the simplest things — including taking his medications. He says the drugs help for a few months, but he knows he is still declining.
"Once I get to the point to where I've lost awareness and I can't recognize Juanita, I don't know who my children are, to me, that's a scary world because I don't know what that feels like," he says.
Researchers hope by studying young people with the disease they will find far better treatments.