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Basic Science and Pathogenesis.

Christian Lachner1, Sheina Emrani2, Lindsey A Kuchenbecker3

  • 1Mayo Clinic in Florida, Jacksonville, FL, USA.

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Summary
This summary is machine-generated.

Alzheimer's disease (AD) onset is not linked to socioeconomic factors. Young-onset AD (YOAD) shows faster decline but longer duration, with more depression and atypical symptoms than late-onset AD (LOAD).

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Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Alzheimer's disease (AD) and related dementias (ADRD) burden is increasing with population aging.
  • Disparities in ADRD suggest socioeconomic and medical factors influence risk, but their link to onset and pathology is unclear.
  • Investigating these associations in diverse populations is crucial for developing effective AD risk reduction strategies.

Purpose of the Study:

  • To investigate the associations between socioeconomic factors, medical comorbidities, age of onset, and neuropathologic findings in Alzheimer's disease (AD).
  • To analyze these associations in an ethnoracially diverse cohort with neuropathologically diagnosed AD.
  • To identify potential targets for AD risk reduction strategies.

Main Methods:

  • Utilized the Florida Autopsied Multi-Ethnic (FLAME) cohort database for neuropathologically-diagnosed AD cases.
  • Included Hispanic/Latino (n=75) and Black/African American (n=22) cases, matched to non-Hispanic White decedents (n=101) by sex and birth year.
  • Retrospectively reviewed medical records for demographics, clinical characteristics, and comorbidities, stratifying by young-onset AD (YOAD, <65 years) and late-onset AD (LOAD, ≥65 years).

Main Results:

  • No significant differences in sex, APOE ε4 carriership, or Area Deprivation Index between YOAD and LOAD.
  • YOAD cases exhibited higher education, longer disease duration, more atypical presentations, faster cognitive decline (MMSE), and higher depression frequency compared to LOAD.
  • YOAD cases showed lower brain weight, less cerebrovascular disease, and higher neurofibrillary tangle density in association cortices than LOAD.

Conclusions:

  • Socioeconomic deprivation and most medical comorbidities were not associated with AD symptomatic onset.
  • Despite higher education and lower cerebrovascular burden, YOAD decedents experienced faster cognitive decline but a longer disease course.
  • YOAD was associated with more frequent atypical clinical presentations and depression compared to LOAD, warranting further investigation into pathology distribution.