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绘制早发性阿尔茨海默病发病前 10 年的发病情况图谱。

Mapping morbidity 10 years prior to a diagnosis of young onset Alzheimer's disease.

机构信息

Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.

出版信息

Alzheimers Dement. 2024 Apr;20(4):2373-2383. doi: 10.1002/alz.13681. Epub 2024 Jan 31.

Abstract

INTRODUCTION

Early symptoms in young onset Alzheimer's disease (YOAD) may be misinterpreted, causing delayed diagnosis. This population-based study aimed to map morbidity prior to YOAD diagnosis.

METHODS

In a register-based incidence density matched nested case-control study, we examined hospital-diagnosed morbidity for people diagnosed with YOAD in Danish memory clinics during 2016-2020 compared to controls in a 10-year period. Conditional logistic regression produced incidence rate ratios (IRRs).

RESULTS

The study included 1745 cases and 5235 controls. YOAD patients had a higher morbidity burden in the year immediately before dementia diagnosis, for certain disorders up to 10 years before. This was especially evident for psychiatric morbidity with the highest increased IRRs throughout the entire period and IRR 1.43 (95% confidence interval 1.14-1.79) in the 5-10-years before dementia diagnosis.

DISCUSSION

YOAD patients display a different pattern of morbidity up to 10 years prior to diagnosis. Awareness of specific alterations in morbidity may improve efforts toward a timely diagnosis.

HIGHLIGHTS

Retrospective, nested case-control study of young onset Alzheimer's disease (YOAD). YOAD cases had a higher morbidity burden than controls. YOAD cases had a higher psychiatric morbidity burden up to 10 years before diagnosis. Altered morbidity patterns could serve as an early warning sign of YOAD.

摘要

简介

早发性阿尔茨海默病(YOAD)的早期症状可能被误解,导致诊断延误。这项基于人群的研究旨在绘制 YOAD 诊断前的发病情况。

方法

在一项基于登记的发病率密度匹配巢式病例对照研究中,我们比较了丹麦记忆诊所 2016 年至 2020 年间诊断为 YOAD 的患者与 10 年内的对照组的医院诊断发病率。条件逻辑回归产生了发病率比(IRR)。

结果

该研究纳入了 1745 例病例和 5235 例对照。在痴呆诊断前的一年内,YOAD 患者的发病负担更高,某些疾病的发病负担甚至提前到 10 年前。精神科发病情况尤为明显,整个时期的最高增加 IRR 为 1.43(95%置信区间 1.14-1.79),在痴呆诊断前 5-10 年期间的 IRR 为 1.43。

讨论

YOAD 患者在诊断前长达 10 年的时间内表现出不同的发病模式。对发病模式的特定改变的认识可能会提高及时诊断的努力。

要点

对早发性阿尔茨海默病(YOAD)的回顾性、嵌套病例对照研究。YOAD 病例的发病负担高于对照组。YOAD 病例的精神科发病负担在诊断前 10 年就更高。改变的发病模式可能成为 YOAD 的早期预警信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8da9/11032518/12de2bbd4da4/ALZ-20-2373-g002.jpg

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