Age of Symptom Onset and Longitudinal Course of Sporadic Alzheimer's Disease, Frontotemporal Dementia, and Vascular Dementia: A Systematic Review and Meta-Analysis

Sally Day, Stefanie Roberts, Nathalie H. Launder, Anita M.Y. Goh, Brian Draper, Alex Bahar-Fuchs, Samantha M. Loi, Kate Laver, Adrienne Withall, Monica Cations

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Understanding how the age of dementia symptom onset affects the longitudinal course of dementia can assist with prognosis and care planning. OBJECTIVE: To synthesize evidence regarding the relationship of age of symptom onset with the longitudinal course of sporadic Alzheimer's disease (AD), vascular dementia (VaD), and frontotemporal dementia (FTD). METHODS: We searched Medline, CINAHL, Embase, PsycINFO, PubMed, and Scopus for longitudinal studies that examined the impact of sporadic AD, VaD, or FTD symptom onset age on measures of cognition, function, or behavioral symptoms. Studies that examined age at diagnosis only were excluded. Quantitative meta-analysis was conducted where studies reported sufficient data for pooling. RESULTS: Thirty studies met all inclusion criteria (people with AD (n = 26), FTD (n = 4)) though no studies examined VaD. Earlier onset of AD was associated with more rapid annual cognitive decline (estimate = -0.07; 95% CI -0.14 to 0.00; p = 0.045). Most studies that stratified their sample reported that younger AD onset (usually < 65 years) was associated with more rapid cognitive decline. Other evidence was inconclusive. CONCLUSION: Younger people with AD appear to have a poorer prognosis in terms of faster cognitive decline than older people with AD. More research is required to determine the impact of symptom onset age in VaD and FTD, and on functional decline in all dementias.

Original languageEnglish
Pages (from-to)1819-1833
Number of pages15
JournalJournal of Alzheimer's disease : JAD
Volume85
Issue number4
DOIs
Publication statusPublished - 15 Feb 2022

Keywords

  • Alzheimer’s disease
  • disease progression
  • frontotemporal dementia
  • prognosis
  • vascular dementia

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