Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, USA.
Am J Alzheimers Dis Other Demen. 2012 Sep;27(6):413-20. doi: 10.1177/1533317512454711. Epub 2012 Aug 7.
Early-onset Alzheimer's disease (EOAD) beginning before the age of 65 may differ from late-onset AD (LOAD) in clinical course and frequency of nonamnestic presentations. In a 10-year retrospective review, 125 patients with EOAD, diagnosed clinically and verified by functional neuroimaging, were compared with 56 patients with LOAD and further classified depending on predominant cognitive difficulty on presentation. Eighty (64%) of the patients with EOAD had a nonamnestic presentation, compared with only 7 (12.5%) of the patients with LOAD. Compared with LOAD, the patients with EOAD had a shorter duration with lower Mini-Mental State Examination scores. The neuroimaging reports among the patients with EOAD showed more hippocampal atrophy with an amnestic presentation, more left parietal changes with impaired language presentations, and more right parietal and occipital changes with impaired visuospatial presentations. These findings indicate that EOAD differs from LOAD in a more aggressive course and in having predominantly nonamnestic presentations that vary in neuropathological location.
早发性阿尔茨海默病（EOAD）是指发病年龄在 65 岁之前，其临床病程和非遗忘型表现的频率可能与晚发性 AD（LOAD）不同。在一项为期 10 年的回顾性研究中，对 125 名经临床诊断并通过功能神经影像学证实的 EOAD 患者与 56 名 LOAD 患者进行了比较，并根据发病时主要认知障碍进行了进一步分类。与 LOAD 患者相比，80 名（64%）EOAD 患者表现为非遗忘型，而 LOAD 患者中仅有 7 名（12.5%）。与 LOAD 相比，EOAD 患者的病程更短，简易精神状态检查评分更低。EOAD 患者的神经影像学报告显示，遗忘型表现患者的海马体萎缩更明显，语言障碍表现患者的左侧顶叶改变更明显，视觉空间障碍表现患者的右侧顶叶和枕叶改变更明显。这些发现表明，EOAD 的病程更为侵袭性，且主要表现为非遗忘型，其神经病理学位置也不同。
