阿尔茨海默病的首发症状与年龄有关：来自国家阿尔茨海默病协调中心（NACC）数据集的证据。
Alzheimer's disease first symptoms are age dependent: Evidence from the NACC dataset.
作者信息
Barnes Josephine, Dickerson Bradford C, Frost Chris, Jiskoot Lize C, Wolk David, van der Flier Wiesje M
机构信息
Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Department of Neurology, Frontotemporal Dementia Unit and Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
Alzheimers Dement. 2015 Nov;11(11):1349-57. doi: 10.1016/j.jalz.2014.12.007. Epub 2015 Apr 24.
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.
引言
确定年龄与阿尔茨海默病（AD）表现之间的关系对于增进理解和提供更好的患者服务至关重要。
方法
我们使用了来自国家阿尔茨海默病协调中心数据库的AD患者数据（N = 7815），并通过多项逻辑回归来研究发病年龄和首发认知/行为症状。
结果
出现非记忆性首发认知症状（包括判断力和解决问题能力、语言及视觉空间功能受损）的几率随年龄降低而增加（P <.001，所有检验）。与淡漠/退缩相比，出现抑郁和“其他”行为症状的几率随年龄降低而增加（P <.02，两项检验），而出现精神病性症状和无行为症状的几率随年龄增加而增加（P <.001，两项检验）。
讨论
AD患者经历的首发认知/行为症状存在相当大的异质性。这些症状的比例随年龄变化，患者在较年轻时会出现越来越多的非记忆性认知症状和更多行为症状。
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