Jaeho Kim1, Sook-Young Woo2, Seonwoo Kim2, Hyemin Jang3,4, Junpyo Kim3,4, Jisun Kim3,4, Sung Hoon Kang5, Duk L Na3,4,6, Juhee Chin3,4, Liana G Apostolova7, Sang Won Seo3,4,6,8, Hee Jin Kim9,10,11,12. 1. Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si, Gyeonggi-do, Republic of Korea. 2. Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea. 3. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea. 5. Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 6. Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. 7. Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA. 8. Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea. 9. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. evekhj@gmail.com. 10. Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea. evekhj@gmail.com. 11. Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. evekhj@gmail.com. 12. Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. evekhj@gmail.com.
Abstract
BACKGROUND: Although few studies have shown that risk factors for Alzheimer's disease (AD) are associated with cognitive decline in AD, not much is known whether the impact of risk factors differs between early-onset AD (EOAD, symptom onset < 65 years of age) versus late-onset AD (LOAD). Therefore, we evaluated whether the impact of Alzheimer's disease (AD) risk factors on cognitive trajectories differ in EOAD and LOAD. METHODS: We followed-up 193 EOAD and 476 LOAD patients without known autosomal dominant AD mutation for 32.3 ± 23.2 months. Mixed-effects model analyses were performed to evaluate the effects of APOE ε4, low education, hypertension, diabetes, dyslipidemia, and obesity on cognitive trajectories. RESULTS: APOE ε4 carriers showed slower cognitive decline in general cognitive function, language, and memory domains than APOE ε4 carriers in EOAD but not in LOAD. Although patients with low education showed slower cognitive decline than patients with high education in both EOAD and LOAD, the effect was stronger in EOAD, specifically in frontal-executive function. Patients with hypertension showed faster cognitive decline than did patients without hypertension in frontal-executive and general cognitive function in LOAD but not in EOAD. Patients with obesity showed slower decline in general cognitive function than non-obese patients in EOAD but not in LOAD. CONCLUSIONS: Known risk factors for AD were associated with slower cognitive decline in EOAD but rapid cognitive decline in LOAD.
BACKGROUND: Although few studies have shown that risk factors for Alzheimer's disease (AD) are associated with cognitive decline in AD, not much is known whether the impact of risk factors differs between early-onset AD (EOAD, symptom onset < 65 years of age) versus late-onset AD (LOAD). Therefore, we evaluated whether the impact of Alzheimer's disease (AD) risk factors on cognitive trajectories differ in EOAD and LOAD. METHODS: We followed-up 193 EOAD and 476 LOAD patients without known autosomal dominant AD mutation for 32.3 ± 23.2 months. Mixed-effects model analyses were performed to evaluate the effects of APOE ε4, low education, hypertension, diabetes, dyslipidemia, and obesity on cognitive trajectories. RESULTS:APOE ε4 carriers showed slower cognitive decline in general cognitive function, language, and memory domains than APOE ε4 carriers in EOAD but not in LOAD. Although patients with low education showed slower cognitive decline than patients with high education in both EOAD and LOAD, the effect was stronger in EOAD, specifically in frontal-executive function. Patients with hypertension showed faster cognitive decline than did patients without hypertension in frontal-executive and general cognitive function in LOAD but not in EOAD. Patients with obesity showed slower decline in general cognitive function than non-obesepatients in EOAD but not in LOAD. CONCLUSIONS: Known risk factors for AD were associated with slower cognitive decline in EOAD but rapid cognitive decline in LOAD.
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