Disease Course Varies According to Age and Symptom Length in Alzheimer's Disease

• Published in: Journal of Alzheimer's disease Vol. 64; no. 2; p. 631
• Main Authors: Barnes, Josephine, Bartlett, Jonathan W, Wolk, David A, van der Flier, Wiesje M, Frost, Chris
• Format: Journal Article
• Language: English
• Published: Netherlands 01.01.2018
• Subjects: Alzheimer’s disease; cognition; cognitive decline; Age factors; age of onset
• ISSN: 1875-8908
• DOI: 10.3233/jad-170841

Health-care professionals, patients, and families seek as much information as possible about prognosis for patients with Alzheimer's disease (AD); however, we do not yet have a robust understanding of how demographic factors predict prognosis. We evaluated associations between age at presentation, age of onset, and symptom length with cognitive decline as measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating sum-of-boxes (CDR-SOB) in a large dataset of AD patients. Age at presentation was associated with post-presentation decline in MMSE (p < 0.001), with younger patients showing faster decline. There was little evidence of an association with change in CDR-SOB. Symptom length, rather than age, was the strongest predictor of MMSE and CDR-SOB at presentation, with increasing symptom length associated with worse outcomes. The evidence that younger AD patients have a more aggressive disease course implies that early diagnosis is essential.