Early Onset Alzheimer's Disease is Associated with a Distinct Neuropsychological Profile

被引：134

作者：

Smits, Lieke L. ^{[1
,2
]}

Pijnenburg, Yolande A. L. ^{[1
,2
]}

Koedam, Esther L. G. E. ^{[1
,2
]}

van der Vlies, Annelies E. ^{[1
,2
]}

Reuling, Ilona E. W. ^{[2
,3
]}

Koene, Teddy ^{[2
,3
]}

Teunissen, Charlotte E. ^{[2
,4
]}

Scheltens, Philip ^{[1
,2
]}

van der Flier, Wiesje M. ^{[1
,2
,5
,6
]}

机构：

[1] Vrije Univ Amsterdam, Dept Neurol, Med Ctr, NL-1007 MB Amsterdam, Netherlands

[2] Vrije Univ Amsterdam, Alzheimer Ctr, Med Ctr, NL-1007 MB Amsterdam, Netherlands

[3] Vrije Univ Amsterdam, Dept Med Psychol, Med Ctr, NL-1007 MB Amsterdam, Netherlands

[4] Vrije Univ Amsterdam, Dept Clin Chem, Med Ctr, NL-1007 MB Amsterdam, Netherlands

[5] Vrije Univ Amsterdam, Dept Neurol Epidemiol, Med Ctr, NL-1007 MB Amsterdam, Netherlands

[6] Vrije Univ Amsterdam, Dept Biostat, Med Ctr, NL-1007 MB Amsterdam, Netherlands

来源：

JOURNAL OF ALZHEIMERS DISEASE | 2012年 / 30卷 / 01期

关键词：

Alzheimer's disease; cognition; dementia; early onset; neuropsychology; DEMENTIA; AGE; DYSFUNCTION; DIAGNOSIS; SUBTYPES; PATTERN; ATROPHY;

D O I：

10.3233/JAD-2012-111934

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Alzheimer's disease (AD) in younger patients is associated with a higher prevalence of atypical symptoms. We examined neuropsychological performance according to age-at-onset. We assessed cognition in 172 patients with AD (81 early and 91 late onset) in five cognitive domains (memory, language, visuo-spatial functioning, executive functioning, attention). Dementia severity was assessed using the Mini-Mental State Examination (MMSE) and global cognitive decline using Cambridge Cognitive Examination (CAMCOG). Analyses of variance were performed with age-at-onset as between-subjects factor, and gender and education as covariates. Analysis was repeated after stratification for dementia severity (based on median MMSE). In early onset AD, age (mean +/- SD) was 60 +/- 4 years; 44 (54%) were female. In late onset AD, age was 72 +/- 5 years; 47 (52%) were female. Dementia severity and global cognitive decline did not differ between groups (early onset: MMSE: 20 +/- 5, CAMCOG: 69 +/- 15, late onset: MMSE: 21 +/- 5, CAMCOG: 70 +/- 15; p > 0.05). Early onset patients performed worse than late onset patients on visuo-spatial functioning (p < 0.01), executive functioning (p < 0.001), and attention (p < 0.01). Late onset patients performed worse on memory, although not significantly (p = 0.11). Stratification for dementia severity showed that in mildly demented early onset patients, memory function was remarkably preserved compared to late onset patients (p < 0.01). In moderate AD, differences in memory function disappeared, but early onset patients performed worse on visuo-spatial functioning (p < 0.01), executive functioning (p < 0.001), and attention (p < 0.01) than late onset patients. Adjustment for APOE left results unchanged. In conclusion, early onset AD presents with a different cognitive profile and the disease course seems different. Relative sparing of memory function in early stages stresses the need to adequately test other cognitive domains.

引用

页码：101 / 108

页数：8

共 37 条

[1]

[Anonymous], 1986, De 15-Woorden test A en B. (Een voorlopige handleiding)

[2]

Benton A., 1989, MULTILINGUAL APHASIA

[3] NEUROPATHOLOGICAL STAGING OF ALZHEIMER-RELATED CHANGES [J].