Early onset Alzheimer’s disease is associated with a distinct neuropsychological profile
Abstract
Alzheimer's disease (AD) in younger patients is associated with a higher prevalence of atypical symptoms. We examined neuropsychological performance according to age-at-onset. We assessed cognition in 172 patients with AD (81 early and 91 late onset) in five cognitive domains (memory, language, visuo-spatial functioning, executive functioning, attention). Dementia severity was assessed using the Mini-Mental State Examination (MMSE) and global cognitive decline using Cambridge Cognitive Examination (CAMCOG). Analyses of variance were performed with age-at-onset as between-subjects factor, and gender and education as covariates. Analysis was repeated after stratification for dementia severity (based on median MMSE). In early onset AD, age (mean ± SD) was 60 ± 4 years; 44 (54%) were female. In late onset AD, age was 72 ± 5 years; 47 (52%) were female. Dementia severity and global cognitive decline did not differ between groups (early onset: MMSE: 20 ± 5, CAMCOG: 69 ± 15, late onset: MMSE: 21 ± 5, CAMCOG: 70 ± 15; p > 0.05). Early onset patients performed worse than late onset patients on visuo-spatial functioning (p < 0.01), executive functioning (p < 0.001), and attention (p < 0.01). Late onset patients performed worse on memory, although not significantly (p = 0.11). Stratification for dementia severity showed that in mildly demented early onset patients, memory function was remarkably preserved compared to late onset patients (p < 0.01). In moderate AD, differences in memory function disappeared, but early onset patients performed worse on visuo-spatial functioning (p < 0.01), executive functioning (p < 0.001), and attention (p < 0.01) than late onset patients. Adjustment for APOE left results unchanged. In conclusion, early onset AD presents with a different cognitive profile and the disease course seems different. Relative sparing of memory function in early stages stresses the need to adequately test other cognitive domains.
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Memory function is generally more disrupted in LOAD patients than in EOAD patients.
“memory function is generally more disrupted in LOAD patients (Jacobs et al., 1994; Koss et al., 1996; Smits et al., 2012)”
From Effects of Alzheimer’s and Vascular Pathologies on Structural Connectivity in Early- and Late-Onset Alzheimer’s Disease (2021) · cites this paper as Smits et al., 2012
EOAD patients exhibit a wider range of cognitive dysfunction, including non-memory cognitive domains, than LOAD patients.
“while EOAD patients exhibit a wider range of cognitive dysfunction, which can also include non-memory cognitive domains (Fujimori et al., 1998; Kaiser et al., 2012; Smits et al., 2012).”
From Effects of Alzheimer’s and Vascular Pathologies on Structural Connectivity in Early- and Late-Onset Alzheimer’s Disease (2021) · cites this paper as Smits et al., 2012
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- Authors
- Smits, L. L., Pijnenburg, Y. A. L., Koedam, E. L. G. E., van der Vlies, A. E., Reuling, I. E. W., Koene, T., Teunissen, C. E., Scheltens, P., & van der Flier, W. M.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
- Venue
- Journal of Alzheimer s Disease
- Publisher
- SAGE Publications
- Published
- 2012-05-04
- Volume
- 30
- Issue
- 1
- Pages
- 101-108
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- OpenAlex
- W1570778022
- Cited by
- 182
- References
- 31
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 9 · 2023: 10 · 2022: 16 · 2021: 10 · 2020: 18 · 2019: 11 · 2018: 9 · 2017: 14 · 2016: 13 · 2015: 26 · 2014: 13 · 2013: 18 · 2012: 4
- FWCI
- 13.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Vanderbilt University Medical Center
- Stichting Dioraphte
- Alzheimer Nederland
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- early-onset Alzheimer's disease, late-onset Alzheimer's disease
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Apolipoproteins E, Attention, Cognition Disorders, Dementia, Female, Humans, Language, Male, Memory, Mental Status Schedule, Mutation, Neuropsychological Tests, Retrospective Studies, Space Perception, Age of Onset, Presenilin-1, Executive Function
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