Alzheimer's disease first symptoms are age dependent: Evidence from the NACC dataset

Determining the relationship between age and Alzheimer's disease (AD) presentation is important to improve understanding and provide better patient services.

We used AD patient data (N = 7815) from the National Alzheimer Coordinating Center database and multinomial logistic regression to investigate presentation age and first cognitive/behavioral symptoms.

The odds of having a nonmemory first cognitive symptom (including impairment in judgment and problem solving, language, and visuospatial function) increased with younger age (P < .001, all tests). Compared with apathy/withdrawal, the odds of having depression and "other" behavioral symptoms increased with younger age (P < .02, both tests), whereas the odds of having psychosis and no behavioral symptom increased with older age (P < .001, both tests).

There is considerable heterogeneity in the first cognitive/behavioral symptoms experienced by AD patients. Proportions of these symptoms change with age with patients experiencing increasing nonmemory cognitive symptoms and more behavioral symptoms at younger ages.