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.


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