Predictors of Age of Diagnosis and Survival of Alzheimer's Disease in Down Syndrome

被引：87

作者：

Sinai, Amanda ^{[1
,2
]}

Mokrysz, Claire ^{[1
]}

Bernal, Jane ^{[3
]}

Bohnen, Ingrid ^{[4
]}

Bonell, Simon ^{[5
,6
,7
]}

Courtenay, Ken ^{[1
,8
]}

Dodd, Karen ^{[9
]}

Gazizova, Dina ^{[10
]}

Hassiotis, Angela ^{[1
,11
]}

Hillier, Richard ^{[11
]}

McBrien, Judith ^{[12
]}

McCarthy, Jane ^{[13
]}

Mukherji, Kamalika ^{[14
]}

Naeem, Asim ^{[15
,16
]}

Perez-Achiaga, Natalia ^{[17
]}

Rantell, Khadija ^{[18
]}

Sharma, Vijaya ^{[14
]}

Thomas, David ^{[19
,20
]}

Walker, Zuzana ^{[1
,21
]}

Whitham, Sarah ^{[3
]}

Strydom, Andre ^{[1
,11
,13
,22
]}

机构：

[1] UCL, Div Psychiat, London, England

[2] Sheba Med Ctr, Tel Hashomer, Israel

[3] Cornwall Partnership Fdn NHS Trust, Bodmin, Cornwall, England

[4] Cent & North West London NHS Fdn Trust, Westminster Learning Disabil Partnership, London, England

[5] Livewell SouthWest CIC, Plymouth, Devon, England

[6] South London & Maudsley NHS Fdn Trust, Maudsley Hosp, London, England

[7] Plymouth Univ, Peninsula Sch Med & Dent, Plymouth, Devon, England

[8] Barnet Enfield & Haringey Mental Hlth NHS Trust, London, England

[9] Surrey & Borders Partnership NHS Fdn Trust, Epsom, Surrey, England

[10] Enfield Integrated Learning Disabil Serv, Enfield, Middx, England

[11] Camden & Islington NHS Fdn Trust, London, England

[12] Plymouth Teaching Primary Care Trust, Livewell Southwest CIC, Plymouth, Devon, England

[13] Kings Coll London, Inst Psychiat Psychol & Neurosci, London, England

[14] Hertfordshire Partnership Univ NHS Fdn Trust, Hatfield, Herts, England

[15] SW London & St Georges Mental Hlth NHS Trust, Sutton MHLD Team, Surbiton, Surrey, England

[16] St Georges Univ London, London, England

[17] Royal Borough Kensington & Chelsea Learning Disab, London, England

[18] Inst Neurol, Educ Unit, Queen Sq, London, England

[19] RAF Marham, Dept Community Mental Hlth, Marham, Norfolk, England

[20] East London NHS Fdn Trust, London, England

[21] Essex Partnership Univ NHS Fdn Trust, Runwell, England

[22] LonDownS Consortium, London, England

来源：

JOURNAL OF ALZHEIMERS DISEASE | 2018年 / 61卷 / 02期

基金：

英国惠康基金;

关键词：

Alzheimer's disease; dementia; Down syndrome; mental retardation; survival; COGNITIVE DECLINE; EARLIER ONSET; OLDER-ADULTS; FOLLOW-UP; OF-ONSET; DEMENTIA; PEOPLE; MORTALITY; COHORT; RISK;

D O I：

10.3233/JAD-170624

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background: People with Down syndrome (DS) are an ultra-high risk population for Alzheimer's disease (AD). Understanding the factors associated with age of onset and survival in this population could highlight factors associated with modulation of the amyloid cascade. Objective: This study aimed to establish the typical age at diagnosis and survival associated with AD in DS and the risk factors associated with these. Methods: Data was obtained from the Aging with Down Syndrome and Intellectual Disabilities (ADSID) research database, consisting of data extracted from clinical records of patients seen by Community Intellectual Disability Services (CIDS) in England. Survival times when considering different risk factors were calculated. Results: The mean age of diagnosis was 55.80 years, SD 6.29. Median survival time after diagnosis was 3.78 years, and median age at death was approximately 60 years. Survival time was associated with age of diagnosis, severity of intellectual disability, living status, anti-dementia medication status, and history of epilepsy. Age at diagnosis and treatment status remained predictive of survival time following adjustment. Conclusion: This study provides the best estimate of survival in dementia within the DS population to date, and is in keeping with previous estimates from smaller studies in the DS population. This study provides important estimates and insights into possible predictors of survival and age of diagnosis of AD in adults with DS, which will inform selection of participants for treatment trials in the future.

引用

页码：717 / 728

页数：12

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