Cognitive Profiles and Neuropsychiatric Symptoms in Korean Early-Onset Alzheimer's Disease Patients: A CREDOS Study

Article type: Research Article

Authors: Park, Hee Kyung^{a; 1} | Choi, Seong Hye^{b; 1} | Park, Sun A.^c | Kim, Hwa Jung^d | Lee, Yunhwan^e | Han, Seol-Heui^f | Kim, Eun-Joo^g | Kim, Byeong C.^h | Han, Hyun Jeoungⁱ | Moon, So Young^j | Yang, Dong Won^k | Park, Kyung Won^l | Park, Kee Hyung^m | Yoon, Boraⁿ | Seo, Sang Won^o | Na, Duk L.^o | Na, Hae Ri^p | Lee, Jae-Hong^{q; *}

Affiliations: [a] Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea | [b] Department of Neurology, Inha University School of Medicine, Incheon, Korea | [c] Department of Neurology, Soonchunhyang University College of Medicine, Bucheon, Korea | [d] Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea | [e] Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea | [f] Department of Neurology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea | [g] Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea | [h] Department of Neurology, Chonnam National University Medical School, Gwangju, Korea | [i] Department of Neurology, Myoungji Hosipital, Goyang, Korea | [j] Department of Neurology, Ajou University School of Medicine, Suwon, Korea | [k] Department of Neurology, Seoul St.Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea | [l] Department of Neurology, Dong-A University College of Medicine, Busan, Korea | [m] Deaprtment of Neurology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea | [n] Department of Neurology, Konyang University College of Medicine, Daejeon, Korea | [o] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea | [p] Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea | [q] Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence: [*] Correspondence to: Jae-Hong Lee, MD, PhD, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea. Tel.: +82 2 3010 3446; Fax: +82 2 474 4691; E-mail: jhlee@amc.seoul.kr.

Note: [1] These authors contributed equally to this work.

Abstract: Background & Objective:Early-onset Alzheimer's disease (EOAD, onset age < 65 years) may differ from late-onset Alzheimer's disease (LOAD) in terms of cognitive profiles and neuropsychiatric symptoms. There have been few studies for Korean EOAD patients using well-structured databases. Previous studies focusing on cognitive profiles between the two groups had a variety of demographic data and comparability. The purpose of this study was to identify the unique profiles of cognitive functions and neuropsychiatric symptoms in Korean EOAD patients that differentiate from LOAD. Methods:Through propensity score matching, a total of 435 patients with EOAD and a total of 435 patients with LOAD were included in this nationwide, multicenter, hospital-based study. Each patient underwent comprehensive neurological examination, interview for caregiver, neuropsychological tests, and brain magnetic resonance imaging. Results:Neuropsychological test results showed worse performances on frontal/executive functions, visuospatial function, and visual memory in EOAD patients as compared to LOAD patients. In terms of neuropsychiatric symptoms, apathy was more common in EOAD patients, while delusions were more prevalent in LOAD patients. The differences in neuropsychiatric symptoms between the two groups were most pronounced in patients with the APOE ε4 allele, suggesting that neuropsychiatric symptoms in AD may be influenced by the APOE genotype. Conclusion:Our results suggested that EOAD may be an important phenotype, fronto-parietal dysfunction, in the spectrum of AD, and this finding can provide for early diagnosis of EOAD patients.

Keywords: Alzheimer's disease, APOE genotype, early-onset dementia, nulticenter study

DOI: 10.3233/JAD-141011

Journal: Journal of Alzheimer's Disease, vol. 44, no. 2, pp. 661-673, 2015