Duration of preclinical, prodromal, and dementia stages of Alzheimer's disease in relation to age, sex, and APOE genotype
Duration of preclinical, prodromal, and dementia stages of Alzheimer's disease in relation to age, sex, and APOE genotype
复制标题
DOI：
10.1016/j.jalz.2019.04.001
复制
发表时间：
2019-07-01
影响因子：
14
通讯作者：
Coley, N.
中科院分区：
文献类型：
--
作者：
Vermunt, Lisa;Sikkes, Sietske A. M.;Coley, N.
简介：我们估计了阿尔茨海默病（AD）临床前、前驱期和痴呆期的年龄特异性持续时间，以及性别、环境、载脂蛋白E（APOE）基因型和脑脊液tau蛋白对疾病持续时间的影响。我们在6个队列的组合样本中进行了多状态建模（n = 3268）与死亡作为结束阶段，并估计临床前，前驱期，痴呆阶段duration.Results：总AD持续时间变化之间的24年（60岁）和15年（80岁）。对于70岁的临床前AD患者，估计的临床前AD持续时间为10年，前驱AD为4年，痴呆为6年。男性性别，临床设置，APOE β 4等位基因携带者，和异常脑脊液tau蛋白与较短的持续时间，这些影响取决于疾病stage.Discussion：估计AD疾病的持续时间变得更加准确，如果年龄，性别，设置，APOE，和脑脊液tau蛋白被考虑在内。这将与临床实践和试验设计相关。(C)2019年，阿尔茨海默氏症协会。爱思唯尔公司出版All rights reserved.
Introduction: We estimated the age-specific duration of the preclinical, prodromal, and dementia stages of Alzheimer's disease (AD) and the influence of sex, setting, apolipoprotein E (APOE) genotype, and cerebrospinal fluid tau on disease duration.Methods: We performed multistate modeling in a combined sample of 6 cohorts (n = 3268) with death as the end stage and estimated the preclinical, prodromal, and dementia stage duration.Results: The overall AD duration varied between 24 years (age 60) and 15 years (age 80). For individuals presenting with preclinical AD, age 70, the estimated preclinical AD duration was 10 years, prodromal AD 4 years, and dementia 6 years. Male sex, clinical setting, APOE epsilon 4 allele carriership, and abnormal cerebrospinal fluid tau were associated with a shorter duration, and these effects depended on disease stage.Discussion: Estimates of AD disease duration become more accurate if age, sex, setting, APOE, and cerebrospinal fluid tau are taken into account. This will be relevant for clinical practice and trial design. (C) 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.