Age at onset and the disturbance of orientation in Alzheimer's disease

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A recent study of Alzheimer's disease (AD) showed a correlation between the disturbance of orientation for time and place and the hypometabolism in the posterior cingulate cortex. In another study of AD, patients with later age at onset have more severe reduction of regional glucose metabolism in the retrosplenial area. These two findings raise a hypothesis that late-onset AD patients have more severe disturbance of orientation than do early-onset patients. We examined the effect of age at onset on the disturbance of orientation using a large sample of mild-to-moderate AD and multivariate statistics controlling for confounding factors. The disturbances were assessed both by the subtest of the Alzheimer's Disease Assessment Scale (ADAS) as neuropsychological measure and by the subscale of the Clinical Dementia Rating (CDR) as clinical measure. The latethan early-onset patients performed significantly worse on the ADAS orientation subtest, and were rated significantly worse on the CDR orientation subscale. The current results confirmed the hypothesis. The clinical characteristic of lateonset patients present a contrast to those of earlyonset patients who are reported to show more profound disturbances of language, attention and visuocognitive functions. The differences between early- and late-onset patients suggest a heterogeneity of AD, and are important to increase the accuracy of early diagnosis and management.
新潟医療福祉大学の論文