Predictors of Disease Progression in Early-Onset Alzheimer's Dementia: A Retrospective Cohort Study

TY - JOUR

T1 - Predictors of Disease Progression in Early-Onset Alzheimer's Dementia

T2 - A Retrospective Cohort Study

AU - Velayudhan, Latha

AU - Baillon, Sarah

AU - Daby, Laura

AU - Suntharamoorthy, Pratheep

AU - Kablan, Alicear

AU - Tromans, Samuel

AU - Lindesay, James

N1 - Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2020/11

Y1 - 2020/11

N2 - OBJECTIVES: Early-onset Alzheimer's disease (EOAD), defined as onset of AD before the age of 65 years, is less common than the late-onset type, and little is known about the factors affecting disease progression. The aim of the study was to investigate factors influencing disease progression in people with EOAD.DESIGN: Retrospective cohort study.SETTING AND PARTICIPANTS: People with EOAD who were assessed and attended the specialist memory service at a university teaching hospital in a European setting, between 2000 and 2010.MEASURES: Sociodemographic details and clinical and cognitive assessments at initial assessment were used as potential predictors of change in clinical status and outcome at final follow-up within the memory service.RESULTS: Of the 101 people diagnosed with EOAD during this period, 96 patients were followed up (53 women; aged 59 ± 4.9 years; mean follow-up 36.3 ± 29.12 months). Patients were classified as Stable (n = 25) if continued within the memory service or discharged to primary care, and those transferred to other specialist services (n = 66) for further inputs, institutional care (n = 4), or died (n = 1) were classified as Worseners (n = 71). Lower education (P = .008), lower Cambridge Cognition Examination scores (P = .049), and presence of family history of dementia [P = .012, χ2 (1) = 8.84] was associated with worse change in clinical status. Furthermore, cognitive deficits such as lower scores on comprehension, recent memory, and executive functions were found to predict a worse clinical outcome.CONCLUSIONS AND IMPLICATIONS: Identification of predictors of faster disease progression has significant clinical benefit, allowing clinicians to estimate prognosis and plan patient care accordingly.

AB - OBJECTIVES: Early-onset Alzheimer's disease (EOAD), defined as onset of AD before the age of 65 years, is less common than the late-onset type, and little is known about the factors affecting disease progression. The aim of the study was to investigate factors influencing disease progression in people with EOAD.DESIGN: Retrospective cohort study.SETTING AND PARTICIPANTS: People with EOAD who were assessed and attended the specialist memory service at a university teaching hospital in a European setting, between 2000 and 2010.MEASURES: Sociodemographic details and clinical and cognitive assessments at initial assessment were used as potential predictors of change in clinical status and outcome at final follow-up within the memory service.RESULTS: Of the 101 people diagnosed with EOAD during this period, 96 patients were followed up (53 women; aged 59 ± 4.9 years; mean follow-up 36.3 ± 29.12 months). Patients were classified as Stable (n = 25) if continued within the memory service or discharged to primary care, and those transferred to other specialist services (n = 66) for further inputs, institutional care (n = 4), or died (n = 1) were classified as Worseners (n = 71). Lower education (P = .008), lower Cambridge Cognition Examination scores (P = .049), and presence of family history of dementia [P = .012, χ2 (1) = 8.84] was associated with worse change in clinical status. Furthermore, cognitive deficits such as lower scores on comprehension, recent memory, and executive functions were found to predict a worse clinical outcome.CONCLUSIONS AND IMPLICATIONS: Identification of predictors of faster disease progression has significant clinical benefit, allowing clinicians to estimate prognosis and plan patient care accordingly.

KW - Alzheimer's disease

KW - disease progression

KW - early onset

KW - outcome

UR - http://www.scopus.com/inward/record.url?scp=85087293868&partnerID=8YFLogxK

U2 - 10.1016/j.jamda.2020.05.016

DO - 10.1016/j.jamda.2020.05.016

M3 - Article

C2 - 32636170

AN - SCOPUS:85087293868

SN - 1525-8610

VL - 21

SP - 1735

EP - 1739

JO - Journal Of The American Medical Directors Association

JF - Journal Of The American Medical Directors Association

IS - 11

ER -