Alzheimer's disease first symptoms are age dependent: Evidence from the NACC dataset

• Published in: Alzheimer's & dementia Vol. 11; no. 11; pp. 1349 - 1357
• Main Authors: Barnes, Josephine, Dickerson, Bradford C, Frost, Chris, Jiskoot, Lize C, Wolk, David, van der Flier, Wiesje M
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2015
• Subjects: Adult; Age; Age of Onset; Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - epidemiology; Alzheimer Disease - physiopathology; Alzheimer Disease - psychology; Alzheimer's disease; Behavior; Clinical neurology history; Cognition; Databases, Factual; Datasets as Topic; Female; First symptoms; Humans; Logistic Models; Male; Middle Aged; Neurology; Neuropsychological Tests; Neuropsychology; United States - epidemiology; United States; First symptoms; Clinical neurology history; Cognition; Behavior; Neuropsychology; Alzheimer's disease; Age
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1016/j.jalz.2014.12.007

Abstract Introduction Determining the relationship between age and Alzheimer's disease (AD) presentation is important to improve understanding and provide better patient services. Methods We used AD patient data (N = 7815) from the National Alzheimer Coordinating Center database and multinomial logistic regression to investigate presentation age and first cognitive/behavioral symptoms. Results The odds of having a nonmemory first cognitive symptom (including impairment in judgment and problem solving, language, and visuospatial function) increased with younger age ( P  <.001, all tests). Compared with apathy/withdrawal, the odds of having depression and “other” behavioral symptoms increased with younger age ( P  <.02, both tests), whereas the odds of having psychosis and no behavioral symptom increased with older age ( P  <.001, both tests). Discussion There is considerable heterogeneity in the first cognitive/behavioral symptoms experienced by AD patients. Proportions of these symptoms change with age with patients experiencing increasing nonmemory cognitive symptoms and more behavioral symptoms at younger ages.