Vertigo and depression show up in the records years before early Alzheimer's. The records, at least, are talking.

People later diagnosed with early-onset Alzheimer's disease — the form that begins before old age — had been treated more often for vertigo, depression, and several other conditions in the one to five years before diagnosis than people of the same age and sex who were not diagnosed. Researchers in Finland report this. The study also found no difference in high blood pressure and high cholesterol between the groups.

So the usual cardiovascular suspects sat this one out.

Published on Oct. 8, 2026, in *Alzheimer's & Dementia*. Laura Leppänen, Johanna Krüger, and colleagues at the University of Oulu and the University of Eastern Finland compared 407 patients diagnosed with early-onset Alzheimer's at two Finnish university hospitals between 2010 and 2021 against 4,035 controls matched for age and sex. Then they read back through Finland's nationwide health registers for the 15 years before diagnosis.

The 407 patients whose records the study read had been diagnosed at two Finnish teaching hospitals, and several of the authors work at one of them. Worth noting.

In the one to five years before diagnosis:

- Vertigo: recorded for 5.9% of patients against 2.1% of controls.

- Depression: 5.7% against 2.3%.

- Headache, delirium, head injuries, thyroid disorders, alcohol-related disorders, epilepsy, stroke, and ear, nose and throat conditions were also more common in the same window.

The differences do not reach much further back. Only ear, nose and throat conditions still separated the two groups six to 10 years before diagnosis. No condition separated them 11 to 15 years before.

The authors conclude that early-onset Alzheimer's is preceded by recognizable patterns of illness and increased use of health services, and that this may support earlier detection.

Their comparison counts diagnoses already written into medical records. It does not show that any of these conditions leads to Alzheimer's. It cannot tell an individual patient anything about their own risk.

That is the part where the headline usually gets ahead of the paper. The registers show association. They do not show causation. They also do not tell you what to do with the information if you happen to have vertigo and depression in your forties. You go to the doctor, presumably. You do not, on the basis of this study, conclude anything about your future.

Figure 1 presents odds ratios on a log scale for 22 groups of conditions in three periods before diagnosis. Delirium, thyroid disorders, epilepsy, and brain injuries sit well above 1.0 in the one to five year period. Cardiovascular risk factors sit on the line in all three periods — the line being 1.0, the line being where nothing interesting is happening.

Points to the right of 1.0 mark conditions recorded more often in patients than in matched controls.

Early-onset Alzheimer's appears to be preceded by a recognizable cluster of conditions and increased healthcare use in the years before diagnosis. That may help with earlier detection. It does not explain the disease. It does not predict individual risk. And it does not, despite what the headlines might suggest, mean that vertigo causes Alzheimer's.

The registers, as always, are talking. It is worth listening carefully — and not hearing more than they said.