O2-04-07: Most rapid cognitive decline in APOE4 negative Alzheimer's disease with early onset

2009 ◽  
Vol 5 (4S_Part_4) ◽  
pp. P111-P112
Author(s):  
Wiesje M. van der Flier ◽  
Annelies E. van der Vlies ◽  
Esther L. Koedam ◽  
Yolande A.L. Pijnenburg ◽  
Jos W.R. Twisk ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Early Onset ◽  
Rapid Cognitive Decline

Most rapid cognitive decline in APOE ε4 negative Alzheimer's disease with early onset

2009 ◽  
Vol 39 (11) ◽  
pp. 1907-1911 ◽  
Author(s):  
A. E. van der Vlies ◽  
E. L. G. E. Koedam ◽  
Y. A. L. Pijnenburg ◽  
J. W. R. Twisk ◽  
P. Scheltens ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Early Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Apoe Genotype ◽  
Apoe Ε4 ◽  
Rapid Cognitive Decline ◽  
State Examination

BackgroundWe aimed to compare the rate of cognitive decline in patients with early and late onset Alzheimer's disease (AD) and to investigate the potentially modifying influence of the apolipoprotein E (APOE) genotype.MethodWe included 99 patients with early onset AD (age ⩽65 years) and 192 patients with late onset AD (age >65 years) who had at least two scores on the Mini-Mental State Examination (MMSE) (range 2–14) obtained at least 1 year apart. Linear mixed models were performed to investigate the rate of cognitive decline dependent on age at onset (AAO) and APOE genotype.ResultsThe mean (s.d.) age for patients with early onset AD was 57.7 (4.5) years, and 74.5 (5.1) years for patients with late onset AD. AAO was not associated with baseline MMSE [β (s.e.)=0.8 (0.5), p=0.14]. However, patients with early onset showed a faster decline on the MMSE [β (s.e.)=2.4 (0.1) points/year] than those with late onset [β (s.e.)=1.7 (0.1) points/year, p=0.00]. After stratification according to APOE genotype, APOE ε4 non-carriers with early onset showed faster cognitive decline than non-carriers with late onset [2.4 (0.3) v. 1.3 (0.3) points/year, p=0.01]. In APOE ε4 carriers, no difference in rate of cognitive decline was found between patients with early and late onset [β (s.e.)=0.2 (0.2), p=0.47].ConclusionPatients with early onset AD show more rapid cognitive decline than patients with late onset, suggesting that early onset AD follows a more aggressive course. Furthermore, this effect seems to be most prominent in patients with early onset who do not carry the genetic APOE ε4 risk factor for AD.

Risk Factors for Rapid Cognitive Decline in Alzheimer’s Disease

2017 ◽  
Vol 7 (5) ◽  
pp. 770-776
Author(s):  
Myung Chul Kim ◽  
Eun Hye Jeong ◽  
Hyun Keun Lee ◽  
Young Kyu Park
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Rapid Cognitive Decline

Early onset APOE E4-negative Alzheimer’s disease patients show faster cognitive decline on non-memory domains

2015 ◽  
Vol 25 (7) ◽  
pp. 1010-1017 ◽  
Author(s):  
Lieke L. Smits ◽  
Yolande A.L. Pijnenburg ◽  
Annelies E. van der Vlies ◽  
Esther L.G.E. Koedam ◽  
Femke H. Bouwman ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Early Onset

Consensus-based recommendations for the management of rapid cognitive decline due to Alzheimer's disease

2017 ◽  
Vol 13 (5) ◽  
pp. 592-597 ◽  
Author(s):  
Jianping Jia ◽  
Serge Gauthier ◽  
Sarah Pallotta ◽  
Yong Ji ◽  
Wenshi Wei ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Rapid Cognitive Decline

scholarly journals Predictors of rapid cognitive decline in Alzheimer's disease: results from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of ageing

2011 ◽  
Vol 24 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Alessandro Sona ◽  
Ping Zhang ◽  
David Ames ◽  
Ashley I. Bush ◽  
Nicola T. Lautenschlager ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Rating Scale ◽  
Cognitive Status ◽  
Imaging Biomarkers ◽  
Clinical Dementia Rating ◽  
Factors Associated ◽  
Biological Variables ◽  
Rapid Cognitive Decline

ABSTRACTBackground: The AIBL study, which commenced in November 2006, is a two-center prospective study of a cohort of 1112 volunteers aged 60+. The cohort includes 211 patients meeting NINCDS-ADRDA criteria for Alzheimer's disease (AD) (180 probable and 31 possible). We aimed to identify factors associated with rapid cognitive decline over 18 months in this cohort of AD patients.Methods: We defined rapid cognitive decline as a drop of 6 points or more on the Mini-Mental State Examination (MMSE) between baseline and 18-month follow-up. Analyses were also conducted with a threshold of 4, 5, 7 and 8 points, as well as with and without subjects who had died or were too severely affected to be interviewed at 18 months and after, both including and excluding subjects whose AD diagnosis was “possible” AD. We sought correlations between rapid cognitive decline and demographic, clinical and biological variables.Results: Of the 211 AD patients recruited at baseline, we had available data for 156 (73.9%) patients at 18 months. Fifty-one patients were considered rapid cognitive decliners (32.7%). A higher Clinical Dementia Rating scale (CDR) and higher CDR “sum of boxes” score at baseline were the major predictors of rapid cognitive decline in this population. Furthermore, using logistic regression model analysis, patients treated with a cholinesterase inhibitor (CheI) had a higher risk of being rapid cognitive decliners, as did males and those of younger age.Conclusions: Almost one third of patients satisfying established research criteria for AD experienced rapid cognitive decline. Worse baseline functional and cognitive status and treatment with a CheI were the major factors associated with rapid cognitive decline over 18 months in this population.

scholarly journals The Pathology of Rapid Cognitive Decline in Clinically Diagnosed Alzheimer’s Disease

2019 ◽  
Vol 70 (4) ◽  
pp. 983-993 ◽  
Author(s):  
Christin Nance ◽  
Aaron Ritter ◽  
Justin B. Miller ◽  
Brittany Lapin ◽  
Sarah J. Banks
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Rapid Cognitive Decline

scholarly journals Trajectories of cognitive decline in Alzheimer's disease

2009 ◽  
Vol 22 (2) ◽  
pp. 281-290 ◽  
Author(s):  
Patricia A. Wilkosz ◽  
Howard J. Seltman ◽  
Bernie Devlin ◽  
Elise A. Weamer ◽  
Oscar L. Lopez ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Complex Disease ◽  
Latent Class ◽  
Rating Scale ◽  
Late Onset ◽  
Psychotic Symptoms ◽  
Concomitant Variables ◽  
Rapid Cognitive Decline

ABSTRACTBackground: Late-onset Alzheimer disease (LOAD) is a clinically heterogeneous complex disease defined by progressively disabling cognitive impairment. Psychotic symptoms which affect approximately one-half of LOAD subjects have been associated with more rapid cognitive decline. However, the variety of cognitive trajectories in LOAD, and their correlates, have not been well defined. We therefore used latent class modeling to characterize trajectories of cognitive and behavioral decline in a cohort of AD subjects.Methods: 201 Caucasian subjects with possible or probable Alzheimer's disease (AD) were evaluated for cognitive and psychotic symptoms at regular intervals for up to 13.5 years. Cognitive symptoms were evaluated serially with the Mini-mental State Examination (MMSE), and psychotic symptoms were rated using the CERAD behavioral rating scale (CBRS). Analyses undertaken were latent class mixture models of quadratic trajectories including a random intercept with initial MMSE score, age, gender, education, and APOE ϵ4 count modeled as concomitant variables. In a secondary analysis, psychosis status was also included.Results: AD subjects showed six trajectories with significantly different courses and rates of cognitive decline. The concomitant variables included in the best latent class trajectory model were initial MMSE and age. Greater burden of psychotic symptoms increased the probability of following a trajectory of more rapid cognitive decline in all age and initial MMSE groups. APOE ϵ4 was not associated with any trajectory.Conclusion: Trajectory modeling of longitudinal cognitive and behavioral data may provide enhanced resolution of phenotypic variation in AD.

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