Camilla Ferrari1, Gemma Lombardi2, Cristina Polito3, Giulia Lucidi2, Silvia Bagnoli2, Irene Piaceri2, Benedetta Nacmias2, Valentina Berti3, Debora Rizzuto4, Laura Fratiglioni4,5, Sandro Sorbi1,2. 1. IRCCS Don Gnocchi, Florence, Italy. 2. Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy. 3. Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Nuclear Medicine Unit, University of Florence, Italy. 4. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 5. Stockholm Gerontology Research Centrum, Stockholm, Sweden.
Abstract
BACKGROUND: Alzheimer's disease (AD) patients present high variability in the rate of cognitive decline. Despite the wide knowledge on factors influencing dementia risk, little is known on what accounts for AD progression. Previous studies on this topic have mainly analyzed each factor separately without taking into account the interaction between genetic and non-genetic factors. OBJECTIVE: The aim of the present study is to evaluate the role of demographic, clinical, therapeutic, and genetic factors and their interaction on cognitive decline among newly diagnosed AD patients. METHODS: We retrospectively selected 160 AD patients diagnosed at the Neurology Unit of Careggi University Hospital of Florence. We evaluated the occurrence of rapid cognitive changes defined as the worsening of more than four points at the Mini-Mental State Examination after 2-year follow up period. RESULTS: Among the 160 AD patients, 50% presented rapid disease progression. Extrapyramidal signs at disease onset were predictors of worse outcome (OR 2.2), especially among Apolipoprotein E (APOE) ɛ4 allele carriers, while the presence of family history for dementia decreased the risk of rapid progression by about 50%. Higher educated ɛ4-carriers showed a slower AD progression. We identified the chronic use of aspirin as potential secondary preventative strategy for the non ɛ4-carriers. CONCLUSION: At dementia onset, some clinical and demographic data can be predictors of future progression. The outcomes of the present study support the already hypothesized interaction between genetic and non-genetic factors during disease course and suggest genetic-based approaches.
BACKGROUND:Alzheimer's disease (AD) patients present high variability in the rate of cognitive decline. Despite the wide knowledge on factors influencing dementia risk, little is known on what accounts for AD progression. Previous studies on this topic have mainly analyzed each factor separately without taking into account the interaction between genetic and non-genetic factors. OBJECTIVE: The aim of the present study is to evaluate the role of demographic, clinical, therapeutic, and genetic factors and their interaction on cognitive decline among newly diagnosed ADpatients. METHODS: We retrospectively selected 160 ADpatients diagnosed at the Neurology Unit of Careggi University Hospital of Florence. We evaluated the occurrence of rapid cognitive changes defined as the worsening of more than four points at the Mini-Mental State Examination after 2-year follow up period. RESULTS: Among the 160 ADpatients, 50% presented rapid disease progression. Extrapyramidal signs at disease onset were predictors of worse outcome (OR 2.2), especially among Apolipoprotein E (APOE) ɛ4 allele carriers, while the presence of family history for dementia decreased the risk of rapid progression by about 50%. Higher educated ɛ4-carriers showed a slower AD progression. We identified the chronic use of aspirin as potential secondary preventative strategy for the non ɛ4-carriers. CONCLUSION: At dementia onset, some clinical and demographic data can be predictors of future progression. The outcomes of the present study support the already hypothesized interaction between genetic and non-genetic factors during disease course and suggest genetic-based approaches.
Authors: G Lombardi; N Lombardi; A Bettiol; G Crescioli; C Ferrari; G Lucidi; C Polito; V Berti; V Bessi; S Bagnoli; B Nacmias; A Vannacci; S Sorbi Journal: Eur J Clin Pharmacol Date: 2022-04-28 Impact factor: 2.953
Authors: Valery Melnikov; Daniel Tiburcio-Jimenez; Martha A Mendoza-Hernandez; Josuel Delgado-Enciso; Luis De-Leon-Zaragoza; Jose Guzman-Esquivel; Iram P Rodriguez-Sanchez; Margarita L Martinez-Fierro; Agustin Lara-Esqueda; Osiris G Delgado-Enciso; Ivan Jacinto-Cortes; Sergio A Zaizar-Fregoso; Brenda A Paz-Michel; Efren Murillo-Zamora; Ivan Delgado-Enciso; Hector R Galvan-Salazar Journal: Am J Transl Res Date: 2021-05-15 Impact factor: 4.060
Authors: Richard Sherva; Alden Gross; Shubhabrata Mukherjee; Ryan Koesterer; Philippe Amouyel; Celine Bellenguez; Carole Dufouil; David A Bennett; Lori Chibnik; Carlos Cruchaga; Jorge Del-Aguila; Lindsay A Farrer; Richard Mayeux; Leanne Munsie; Ashley Winslow; Stephen Newhouse; Andrew J Saykin; John S K Kauwe; Paul K Crane; Robert C Green Journal: Alzheimers Dement Date: 2020-06-23 Impact factor: 16.655
Authors: Samuel C Ugbaja; Isiaka A Lawal; Bahijjahtu H Abubakar; Aganze G Mushebenge; Monsurat M Lawal; Hezekiel M Kumalo Journal: Molecules Date: 2022-07-08 Impact factor: 4.927