Predictive Factors for Disease Progression in Patients With Early-Onset Alzheimer’s Disease

Article type: Research Article

Authors: Yoon, Bora^a | Shim, Yong S.^b | Park, Hee-Kyung^c | Park, Sun Ah^d | Choi, Seong Hye^e | Yang, Dong Won^{f; *}

Affiliations: [a] Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Republic of Korea | [b] Department of Neurology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea | [c] Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea | [d] Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea | [e] Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea | [f] Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Correspondence: [*] Correspondence to: Dong Won Yang, MD, PhD, Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 505 Banpo-dong, Seocho-gu, 137-040, Seoul, Republic of Korea. Tel.: +82 2 2258 6077; Fax: +82 2 599 9686; E-mail: neuroman@catholic.ac.kr

Abstract: Background:Only a few studies have investigated disease progression in patients with early-onset Alzheimer’s disease (EOAD). Therefore, the aim of this study was to investigate disease progression in patients with EOAD and the influence of various factors, such as gender, education, and apolipoprotein E (APOE) genotype on disease progression. Methods:A total of 288 EOAD patients were enrolled in the study. Linear mixed models were used to investigate the rate of cognitive and functional decline in terms of age at onset, gender, education, follow-up period, and APOE genotype. Results:EOAD patients showed an annual decline of –1.54 points/years in the Korean version mini-mental examination score, an annual increase of 3.46 points/year in the Seoul instrumental activities of daily living (SIADL) score, and an annual increase of 1.15 points/year in the clinical dementia rating scale-sum of boxes score. After stratification, higher educated patients showed faster disease progression in all three parameters, and female patients demonstrated faster disease progression as assessed by the SIADL score. Age at onset and APOE genotype had no influence on disease progression. Conclusion:We confirmed the rate of disease progression in Korean patients with EOAD in real-life hospital-based clinical practice. The results of this study suggest that education and female gender, not APOE genotype, may be important as independent strong predictive factors for disease progression in patients with EOAD.

Keywords: Alzheimer’s disease, cognitive reserve, disease progression, early-onset, education, longitudinal study

DOI: 10.3233/JAD-150462

Journal: Journal of Alzheimer's Disease, vol. 49, no. 1, pp. 85-91, 2016