Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Letters to the Editor
6 (
3
); 455-456
doi:
10.4103/0976-3147.154581

Early and late-onset Alzheimer's disease: What are the differences?

Department of Neurology, Hôtel-Dieu Hospital, Saint Joseph University, Beirut, Lebanon

Address for correspondence: Prof. Adnan A. Awada, Department of Neurology, Hôtel-Dieu Hospital, Saint Joseph University, Beirut, Lebanon. E-mail: awadaadnan@yahoo.com

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

Dear Sir,

Alzheimer's disease is the most common cause of dementia all over the world and its incidence and prevalence increase with age. About 5% of patients develop symptoms before age 65 and are labelled “patients with early-onset Alzheimer's disease” (EOAD). Most of these patients have the sporadic form of the disease, but 10-15% have a genetic form that is generally inherited as an autosomal dominant fashion. Three genes have been incriminated: Presenilin 1 and 2 and APP gene. A mutation of these genes leads to EOAD. Other candidate genes are also under study. Genetic forms tend to start at age 30 or 40 and have an aggressive course while sporadic EOAD tend to start after age 50 and have, in general, a temporal profile similar to the “late onset Alzheimer's disease” (LOAD) one.

It is classical to divide AD symptoms into cognitive (memory loss, disorientation, language difficulties, visuospatial problems, apraxia, etc.) and non-cognitive symptoms (mood swing, delusions, hallucinations, misbehavior, etc). There have been only few papers dealing with the differences in neuropsychiatric symptoms between EOAD and LOAD.[1234] In the study of Toyota et al.,[1] behavioral and psychological symptoms were relatively fewer in EOAD than LOAD, while there were no differences in cognitive functions or dementia severity between two groups. In the largest and most recent study from Korea,[4] apathy was more common in EOAD patients, while delusions were more prevalent in LOAD patients. The differences in neuropsychiatric symptoms between the two groups were most pronounced in patients with the APOE ε4 allele, suggesting that neuropsychiatric symptoms in AD may be influenced by the APOE genotype. In another paper where anxiety was studied more specifically,[3] this symptom was associated with higher Mini-Mental State Exam score, and separation from caregivers in patients with EOAD while it was associated with psychotic and activating psychiatric symptoms in those with LOAD.

Important issue in AD is its social impact. EOAD can have devastating effects on the careers, caregivers and family members of patients. Patients who are working lose their ability to perform their jobs competently, and are forced into early retirement. Finances get even tighter if spouses or partners also quit their jobs to become full-time caregivers. This social impact is probably more devastating in countries like India and other third-world places where the majority of population lives below poverty line and patients with AD are kept in their families.

References

  1. , , , , , , , , , , , , . Comparison of behavioral and psychological symptoms in early-onset and late-onset Alzheimer's disease. Int J Geriatr Psychiatry. 2007;22:896-901.
    [Google Scholar]
  2. , , , , , . Clinical heterogeneity of Alzheimer's disease according to the age of onset. Rev Neurol (spain). 2007;45:67-72.
    [Google Scholar]
  3. , , , , , , . Differences in anxiety among patients with early- versus late-onset Alzheimer's disease. J Neuropsychiatry Clin Neurosci. 2014;26:73-80.
    [Google Scholar]
  4. , , , , , , . Cognitive profiles and neuropsychiatric symptoms in Korean early-onset Alzheimer's disease patients: A CREDOS study. J Alzheimers Dis. 2015;44:661-73.
    [Google Scholar]

    Fulltext Views
    884

    PDF downloads
    495
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections