Risk factors for earlier dementia onset in autopsy-confirmed Alzheimer's disease, mixed Alzheimer's with Lewy bodies, and pure Lewy body disease

Jeff Schaffert; Christian LoBue; Charles L White 3rd; Kristin Wilmoth; Nyaz Didehbani; Laura Lacritz; Trung Nguyen; Matthew E Peters; Lindy Fields; Chengxi Li; C Munro Cullum

doi:10.1002/alz.12049

Risk factors for earlier dementia onset in autopsy-confirmed Alzheimer's disease, mixed Alzheimer's with Lewy bodies, and pure Lewy body disease

Alzheimers Dement. 2020 Mar;16(3):524-530. doi: 10.1002/alz.12049. Epub 2020 Feb 11.

Authors

Jeff Schaffert¹, Christian LoBue^{1

2}, Charles L White 3rd³, Kristin Wilmoth⁴, Nyaz Didehbani¹, Laura Lacritz^{1

5}, Trung Nguyen⁵, Matthew E Peters⁶, Lindy Fields⁷, Chengxi Li⁸, C Munro Cullum^{1

5

2}

Affiliations

¹ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
² Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
³ Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁴ Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
⁵ Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁶ Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
⁷ Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
⁸ Medical School, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Abstract

Introduction: Clinical Alzheimer's disease (AD) and dementia with Lewy bodies often have mixed AD and Lewy pathology, making it difficult to delineate risk factors.

Methods: Six risk factors for earlier dementia onset due to autopsy-confirmed AD (n = 647), mixed AD and Lewy body disease (AD + LBD; n = 221), and LBD (n = 63) were entered into multiple linear regressions using data from the National Alzheimer's Coordinating Center.

Results: In AD and AD + LBD, male sex and apolipoprotein E (APOE) ɛ4 alleles each predicted a 2- to 3-year-earlier onset and depression predicted a 3-year-earlier onset. In LBD, higher education predicted earlier onset and depression predicted a 5.5-year-earlier onset.

Discussion: Male sex and APOE ɛ4 alleles increase risk for earlier dementia onset in AD but not LBD. Depression increases risk for earlier dementia onset in AD, LBD, and AD + LBD, but evaluating the course, treatment, and severity is needed in future studies.

Keywords: Alzheimer's disease; Lewy body disease; dementia; onset; risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Alzheimer Disease* / genetics
Alzheimer Disease* / pathology
Autopsy*
Brain / pathology
Depression
Educational Status*
Female
Humans
Lewy Body Disease / pathology*
Male
Risk Factors
Sex Factors

Abstract

Publication types

MeSH terms

Grants and funding