Alzheimer's disease first symptoms are age dependent: Evidence from the NACC dataset.
BACKGROUND
Determining the relationship between age and Alzheimer's disease (AD) presentation is important to improve understanding and provide better patient services.


METHODS
We used AD patient data (N = 7815) from the National Alzheimer Coordinating Center database and multinomial logistic regression to investigate presentation age and first cognitive/behavioral symptoms.


RESULTS
The odds of having a nonmemory first cognitive symptom (including impairment in judgment and problem solving, language, and visuospatial function) increased with younger age (P < .001, all tests). Compared with apathy/withdrawal, the odds of having depression and "other" behavioral symptoms increased with younger age (P < .02, both tests), whereas the odds of having psychosis and no behavioral symptom increased with older age (P < .001, both tests).


CONCLUSIONS
There is considerable heterogeneity in the first cognitive/behavioral symptoms experienced by AD patients. Proportions of these symptoms change with age with patients experiencing increasing nonmemory cognitive symptoms and more behavioral symptoms at younger ages.
Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK. Electronic address: j.barnes@ucl.ac.uk.
Josephine
J
Barnes
Department of Neurology, Frontotemporal Dementia Unit and Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Bradford C
BC
Dickerson
Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Chris
C
Frost
Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands.
Lize C
LC
Jiskoot
Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA.
David
D
Wolk
Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Epidemiology & Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
Wiesje M
WM
van der Flier
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D001519:Behavior; D003071:Cognition; D016208:Databases, Factual; D066264:Datasets as Topic; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D014481:United States / Q000453:epidemiology
Age; Alzheimer's disease; Behavior; Clinical neurology history; Cognition; First symptoms; Neuropsychology