Factors associated with mortality in patients with early‐onset Alzheimer's disease: a five‐year longitudinal study

Abstract

To identify neuropsychiatric and somatic factors related to survival in early-onset Alzheimer's disease, we longitudinally studied 108 patients (35 male, 73 female) with early-onset Alzheimer's disease who were 46 to 64 years old at onset and 50 to 69 years old when diagnosed at our institution. A five-year follow-up, 30 patients had died. Pneumonia was the most common cause (73%), followed by malignancy (20%) and heart disease (7%). Kaplan-Meier survival curves showed a lower survival rate in patients with early-onset Alzheimer's disease than in age- and sex-matched life-table data in Japan. In Cox proportional hazards analysis, male gender, early disease onset, concurrent physical illness at time of diagnosis, and a low mini-mental state examination score increased the likelihood of death in patients with early-onset Alzheimer's disease. Our study confirmed that these patients have considerable excess mortality and a different pattern of cause of death than in the general population. Gender, age at onset, physical illness, and cognitive function strongly influenced survival. These factors may be predictors of mortality in patients with early-onset Alzheimer's disease that are useful in counseling patients and their families.

Innate Gender-based Proclivity in Response to Cytotoxicity and Programmed Cell Death Pathway

“…Consistent with the in vitro data in the present study, men are more susceptible than women to both Parkinson's and Alzheimer's diseases (6,7,12,13) and ischemia after cardiac arrest (14). In addition, boys have worse outcome after traumatic brain injury than girls (9), and men demonstrate a greater degree of lipid peroxidation than women after traumatic brain injury (29).…”

“…Elderly men have a higher incidence of Parkinson's disease and do not respond as well to surgical intervention compared with elderly females (6,7). Elderly men with Alzheimer's disease have an earlier onset and increased mortality compared with elderly females (12,13). In a study examining patients after cardiac arrest where the mean age was 67 years, male gender, but not age, was associated with poor outcome (14).…”

Oxidative Stress, Perturbed Calcium Homeostasis, and Immune Dysfunction in Alzheimer's Disease

“…Peripheral consequences of a compromised immune system are may also contribute to the clinical course of AD. AD patients exhibit increased susceptibility to infection, with pneumonia being the most common cause of death in patients with lateonset AD, as well as in patients with familial earlyonset disease (Ueki et al, 2001). Goals for future studies include (1) elucidation of the specific molecular and cellular alterations of peripheral and central immune cells in AD; (2) establishing the links between transmissible and nontransmissible neurodegenerative disorders; and (3) the development of pharmacological and dietary interventions that may normalize immune function in viral and prion disorders and AD.…”

Predictors of mortality in frontotemporal dementia: a retrospective study of the prognostic influence of pre‐diagnostic features

“…Physical comorbidity is known to influence the mortality (Boersma et al, 1999;Ueki et al, 2001) and could thus interfere with dementia-specific pathology. Another such factor are the possible sideeffects of neuroleptic drugs, associated with increased mortality due to cardiac arrythmias (Glassman and Bigger, 2001;Ray et al, 2001).…”