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Most rapid cognitive decline in APOE epsilon4 negative Alzheimer's disease with early onset.
Psychol Med 2009; 39(11):1907-11PM

Abstract

BACKGROUND

We aimed to compare the rate of cognitive decline in patients with early and late onset Alzheimer's disease (AD) and to investigate the potentially modifying influence of the apolipoprotein E (APOE) genotype.

METHOD

We included 99 patients with early onset AD (age 65 years) and 192 patients with late onset AD (age >65 years) who had at least two scores on the Mini-Mental State Examination (MMSE) (range 2-14) obtained at least 1 year apart. Linear mixed models were performed to investigate the rate of cognitive decline dependent on age at onset (AAO) and APOE genotype.

RESULTS

The mean (S.D.) age for patients with early onset AD was 57.7 (4.5) years, and 74.5 (5.1) years for patients with late onset AD. AAO was not associated with baseline MMSE [beta (S.E.)=0.8 (0.5), p=0.14]. However, patients with early onset showed a faster decline on the MMSE [beta (S.E.)=2.4 (0.1) points/year] than those with late onset [beta (S.E.)=1.7 (0.1) points/year, p=0.00]. After stratification according to APOE genotype, APOE epsilon4 non-carriers with early onset showed faster cognitive decline than non-carriers with late onset [2.4 (0.3) v. 1.3 (0.3) points/year, p=0.01]. In APOE epsilon4 carriers, no difference in rate of cognitive decline was found between patients with early and late onset [beta (S.E.)=0.2 (0.2), p=0.47].

CONCLUSION

Patients with early onset AD show more rapid cognitive decline than patients with late onset, suggesting that early onset AD follows a more aggressive course. Furthermore, this effect seems to be most prominent in patients with early onset who do not carry the genetic APOE epsilon4 risk factor for AD.

Authors+Show Affiliations

Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. ae.vdvlies@vumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19335933

Citation

van der Vlies, A E., et al. "Most Rapid Cognitive Decline in APOE Epsilon4 Negative Alzheimer's Disease With Early Onset." Psychological Medicine, vol. 39, no. 11, 2009, pp. 1907-11.
van der Vlies AE, Koedam EL, Pijnenburg YA, et al. Most rapid cognitive decline in APOE epsilon4 negative Alzheimer's disease with early onset. Psychol Med. 2009;39(11):1907-11.
van der Vlies, A. E., Koedam, E. L., Pijnenburg, Y. A., Twisk, J. W., Scheltens, P., & van der Flier, W. M. (2009). Most rapid cognitive decline in APOE epsilon4 negative Alzheimer's disease with early onset. Psychological Medicine, 39(11), pp. 1907-11. doi:10.1017/S0033291709005492.
van der Vlies AE, et al. Most Rapid Cognitive Decline in APOE Epsilon4 Negative Alzheimer's Disease With Early Onset. Psychol Med. 2009;39(11):1907-11. PubMed PMID: 19335933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Most rapid cognitive decline in APOE epsilon4 negative Alzheimer's disease with early onset. AU - van der Vlies,A E, AU - Koedam,E L G E, AU - Pijnenburg,Y A L, AU - Twisk,J W R, AU - Scheltens,P, AU - van der Flier,W M, Y1 - 2009/04/01/ PY - 2009/4/2/entrez PY - 2009/4/2/pubmed PY - 2010/2/18/medline SP - 1907 EP - 11 JF - Psychological medicine JO - Psychol Med VL - 39 IS - 11 N2 - BACKGROUND: We aimed to compare the rate of cognitive decline in patients with early and late onset Alzheimer's disease (AD) and to investigate the potentially modifying influence of the apolipoprotein E (APOE) genotype. METHOD: We included 99 patients with early onset AD (age 65 years) and 192 patients with late onset AD (age >65 years) who had at least two scores on the Mini-Mental State Examination (MMSE) (range 2-14) obtained at least 1 year apart. Linear mixed models were performed to investigate the rate of cognitive decline dependent on age at onset (AAO) and APOE genotype. RESULTS: The mean (S.D.) age for patients with early onset AD was 57.7 (4.5) years, and 74.5 (5.1) years for patients with late onset AD. AAO was not associated with baseline MMSE [beta (S.E.)=0.8 (0.5), p=0.14]. However, patients with early onset showed a faster decline on the MMSE [beta (S.E.)=2.4 (0.1) points/year] than those with late onset [beta (S.E.)=1.7 (0.1) points/year, p=0.00]. After stratification according to APOE genotype, APOE epsilon4 non-carriers with early onset showed faster cognitive decline than non-carriers with late onset [2.4 (0.3) v. 1.3 (0.3) points/year, p=0.01]. In APOE epsilon4 carriers, no difference in rate of cognitive decline was found between patients with early and late onset [beta (S.E.)=0.2 (0.2), p=0.47]. CONCLUSION: Patients with early onset AD show more rapid cognitive decline than patients with late onset, suggesting that early onset AD follows a more aggressive course. Furthermore, this effect seems to be most prominent in patients with early onset who do not carry the genetic APOE epsilon4 risk factor for AD. SN - 1469-8978 UR - https://www.unboundmedicine.com/medline/citation/19335933/Most_rapid_cognitive_decline_in_APOE_epsilon4_negative_Alzheimer's_disease_with_early_onset_ L2 - https://www.cambridge.org/core/product/identifier/S0033291709005492/type/journal_article DB - PRIME DP - Unbound Medicine ER -