Early‐onset Alzheimer's disease: a global cross‐sectional analysis

Abstract

Early-onset Alzheimer's disease is found more frequently in Native American Indians, Alaskans, Hawaiians and other minorities, including Hispanics; patients with EOAD have more anxiety or depression. EOAD occurs independently of hypertension, stroke and atrial fibrillation.

Controlled population-based comparative study of USA and international adult [55-74] neurological deaths 1989-2014

“…There are confirmed rises of ALS from a number of Western clinical studies1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 25 as well as small increases in Asian and Latin American countries 18, 19…”

“…This was followed‐up in a second international study taking the results to 2010. The latter analysis used the later baseline years of 1989‐91, which confirmed the earlier onset of neurological morbidity and that neurological deaths continued to increase in the majority of the countries reviewed 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12. Rises in USA the over‐75s neurological deaths were considerable as the USA had significantly greater increases than fourteen of the other twenty nations, with threefold rises in American men and a fivefold increase in women in just 21 years 8.…”

“…Moreover, compared with the earlier analyses between 1989 and 2010 where there were notable rises in males in six countries and in four countries for females, by 2014 there had been rises of equivalent to >10% in twelve countries for men and in eleven countries for females. A Gompertzian perspective also ignores rises in early onset dementia (EOD) reported in many countries 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 19, 20, 22, 25. For example, one found 29% of their cohort were aged under 65 years, which 30 years before would have been considered extraordinary 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 19, 20, 22, 25.…”

“…However, the diagnostic issue has limited impact as it is mortality rates that are measured not separate diagnostic categories, and at this point, there is little evidence of diagnostic uncertainty as the primary cause of death is categorized as being due to a neurological condition 1, 5, 6, 7, 8. Moreover, the Gompertzian position appears to have ignored the marked changes between the sexes and in different countries 1, 5, 6, 7, 8, 9, 10, 11. Crucially, the Gompertzian hypothesis does not account for the substantial rise in early onset dementia reported in many Western countries 12, 13, 18, 19, 20, 21, 22…”

Rapidly Progressive Young-Onset Dementias

“…Similar to sCJD, YOAD seems to be more prevalent in certain minority populations (Native American Indian, Alaskan, Hawaiian, and Hispanics). 27 Common risk factors for late-onset AD, such as Apolipoprotein E4 gene (APOE4) alleles, hypertension, stroke, and atrial fibrillation, are less common in YOAD. 27,28 Approximately one-third of those with YOAD have an atypical, nonamnestic presentation that often leads to an incorrect initial diagnosis.…”