Early-Versus Late-Onset Alzheimer's Disease: More than Age Alone
Early-Versus Late-Onset Alzheimer's Disease: More than Age Alone
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DOI：
10.3233/jad-2010-1337
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发表时间：
2010-01-01
影响因子：
4
通讯作者：
Pijnenburg, Yolande A. L.
中科院分区：
文献类型：
--
作者：
Koedam, Esther L. G. E.;Lauffer, Vivian;Pijnenburg, Yolande A. L.
阿尔茨海默病（AD）是老年痴呆症最常见的原因。虽然在65岁之前不太普遍，但它仍然是早发性痴呆的最常见原因，其次是额颞叶痴呆。AD的典型表现是记忆功能障碍，然而，除了记忆之外，在其他领域也可能出现明显的认知障碍，如明显的失用症、语言问题或执行功能障碍，并且在早发性AD中相对更常见。在这项回顾性描述性研究中，我们确定了大样本早发性AD患者与晚发性AD患者相比的非记忆表现的患病率。回顾了270例65岁以前开始的AD患者和90例迟发性AD（>= 65岁）患者的临床资料，以评估其临床特征。根据临床表现将患者分为记忆型和非记忆型。早发组的平均年龄为56 ± 5岁，晚发组为74 ± 6岁。早发性AD组中有三分之一的人出现非记忆症状，而晚发性AD组中只有6%出现非记忆症状（p < 0.001）。在非记忆表现组中，失用症/视觉空间功能障碍是最常见的表现症状（12%）。早发性AD患者通常表现为非记忆表型，其中失用症/视觉空间功能障碍是最常见的表现症状。在早发性痴呆的临床鉴别诊断中，应考虑AD的非典型表现。
Alzheimer's disease (AD) is the most common cause of dementia at older age. Although less prevalent before the age of 65 years, it is still the most frequent cause of early-onset dementia followed by frontotemporal dementia. The typical presentation of AD is memory dysfunction, however, presentations with prominent cognitive impairment in other domains besides memory, like prominent apraxia, language problems, or executive dysfunction, may occur and are relatively more common in early-onset AD. In this retrospective descriptive study, we determined the prevalence of non-memory presentations in a large sample of early-onset AD patients compared to late-onset AD. The clinical files of 270 patients with AD starting before the age of 65 years and 90 patients with late-onset AD (>= 65 years) were reviewed to assess clinical characteristics. Patients were classified as memory presentation and non-memory presentation according to their clinical presentation. The mean age of the early-onset group was 56 +/- 5 years and 74 +/- 6 years for the late-onset group. A third of the early-onset AD group presented with non-memory symptoms compared to only 6% in the late-onset group (p < 0.001). Within the group with non-memory presentations, apraxia/visuospatial dysfunction was the most prevalent presenting symptom (12%). Patients with early-onset AD often present with a non-memory phenotype, of which apraxia/visuospatial dysfunction is the most common presenting symptom. Atypical presentations of AD should be considered in the clinical differential diagnosis of early-onset dementia.