Predictors of Disease Progression in Early-Onset Alzheimer's Dementia: A Retrospective Cohort Study.

OBJECTIVES

Early-onset Alzheimer's disease (EOAD), defined as onset of AD before the age of 65 years, is less common than the late-onset type, and little is known about the factors affecting disease progression. The aim of the study was to investigate factors influencing disease progression in people with EOAD.

DESIGN

Retrospective cohort study.

SETTING AND PARTICIPANTS

People with EOAD who were assessed and attended the specialist memory service at a university teaching hospital in a European setting, between 2000 and 2010.

MEASURES

Sociodemographic details and clinical and cognitive assessments at initial assessment were used as potential predictors of change in clinical status and outcome at final follow-up within the memory service.

RESULTS

Of the 101 people diagnosed with EOAD during this period, 96 patients were followed up (53 women; aged 59 ± 4.9 years; mean follow-up 36.3 ± 29.12 months). Patients were classified as Stable (n = 25) if continued within the memory service or discharged to primary care, and those transferred to other specialist services (n = 66) for further inputs, institutional care (n = 4), or died (n = 1) were classified as Worseners (n = 71). Lower education (P = .008), lower Cambridge Cognition Examination scores (P = .049), and presence of family history of dementia [P = .012, χ (1) = 8.84] was associated with worse change in clinical status. Furthermore, cognitive deficits such as lower scores on comprehension, recent memory, and executive functions were found to predict a worse clinical outcome.

CONCLUSIONS AND IMPLICATIONS

Identification of predictors of faster disease progression has significant clinical benefit, allowing clinicians to estimate prognosis and plan patient care accordingly.