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

Little is known about factors associated with early-onset Alzheimer's disease (EOAD), which occurs before 65 years of age. The identification of factors of EOAD might provide insights into Alzheimer's disease (AD) pathogenesis.

Data from over 3000 subjects with AD from C-Path Online Data Repository were used to compare demographics, comorbidities and prescribed medications between EOAD and late-onset Alzheimer's disease (LOAD). The generalized estimating equations binomial model was used to identify factors associated with EOAD, allowing for within-trials correlation (multiple patients from one single trial).

Despite the similar proportions in White, Asian and Black between EOAD and LOAD, a significantly higher proportion of EOAD population was from other races: Native American Indian, Alaskan and Hawaiian and other minorities (including Hispanics) (P < 0.0001); and were more likely to have anxiety or depression (P < 0.0001). A high proportion of the LOAD population reported a history of AD from any relative (70% vs. 58%); atrial fibrillation, hypertension, heart disease, stroke, hypercholesterolaemia and hypothyroidism were over-represented in LOAD (P < 0.01). LOAD patients used more risperidone and donepezil (P < 0.01). The multivariable model results showed that, compared with LOAD, EOAD patients were more frequently from other races and were more likely to have anxiety or depression, with less hypertension, stroke and atrial fibrillation.

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.