Time to diagnosis in young-onset dementia as compared with late-onset dementia

Vliet, Deliane van; Vugt, Marjolein E. de; Bakker, Christian; Pijnenburg, Yolande A.L.; Vernooij‐Dassen, Myrra; Koopmans, Raymond T.C.M.; Verhey, Frans R.J.

doi:10.1017/s0033291712001122

Cited by 218 publications

(287 citation statements)

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“…Behavioral changes are common debut symptoms in YOD [6, 7], and often misattributed to stress or depression. However, the phenotype of AD in younger people may also diverge from what is seen in older people, with atypical presentations [8] contributing to misattribution of symptoms and prolonged time to diagnosis [2, 9]. The progression of YOD seems to have a more malignant course compared to late-onset dementia (LOD), with more rapid decline and shorter survival [10-12].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

Hvidsten

Engedal

Selbæk

et al. 2018

Dement Geriatr Cogn Disord

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Aims: The aims of this study were to compare quality of life (QOL) in people with young-onset Alzheimer’s (AD) and frontotemporal (FTD) dementia, explore variables associated with QOL, and compare QOL in young-onset dementia (YOD) and late-onset dementia (LOD). Methods: Cross-sectional data from a Nordic multicenter study of 50 community-dwelling participants with AD and 38 with FTD were included. A comparison group consisted of 100 people with LOD. QOL was measured using self-reported Euro-QOL 5-Dimension and the proxy version of Quality of Life in Alzheimer’s Disease (QOL-AD) questionnaire. Neuropsychiatric symptoms and needs were assessed using the Cornell Scale for Depression in Dementia (CSDD), Neuropsychiatric Inventory (NPI), and Camberwell Assessment of Needs in the Elderly. Multiple linear regression and multilevel modeling was used to determine variables associated with QOL. Results: We found no differences between the two YOD groups in QOL. The variables associated with QOL were scores on the CSDD, NPI, and unmet needs. The proxy QOL-AD score in YOD was significantly higher compared to LOD (median 36.0 [IQR 10.0] vs. 33.0 [IQR 9.0]). Conclusion: The QOL in Nordic people with YOD was better compared to people with LOD. Our results show depressive symptoms to be associated with QOL irrespective of age and diagnosis.

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Section: Introductionmentioning

confidence: 99%

Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

Hvidsten

Engedal

Selbæk

et al. 2018

Dement Geriatr Cogn Disord

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“…People with young-onset dementia (YOD), defined as dementia with an onset of symptoms before the age of 65 years, often encounter specific challenges such as a substantial delay in diagnosis, loss of employment, financial issues, social isolation, changes in relationships, and lack of meaningful daytime activities, all adding to the negative impact on QoL [19][20][21][22] . Indeed, current research suggests that younger age is associated with a worse QoL in LOD [9] .…”

Section: Introductionmentioning

confidence: 99%

The Determinants of Quality of Life of Nursing Home Residents with Young-Onset Dementia and the Differences between Dementia Subtypes

Appelhof¹,

Bakker

IJssel

et al. 2017

Dement Geriatr Cogn Disord

1,696

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Aims:The aims of this study are to (1) explore the determinants of quality of life (QoL) in nursing home residents with young-onset dementia (YOD), (2) investigate whether there are differences between dementia subtypes (Alzheimer dementia, vascular/mixed dementia, frontotemporal dementia, other) regarding these determinants, and (3) compare QoL profiles of YOD nursing home residents across dementia subtypes. Methods: This cross-sectional study included 207 nursing home residents. Multilevel modeling was used to determine the relationships between QoL and neuropsychiatric symptoms (NPS), dementia severity, psychotropic drug use (PDU), dementia subtype, age, and gender. Additional multilevel models were used to compare aspects of QoL between dementia subtypes. Results: Residents' QoL was negatively associated with advanced dementia, PDU, and NPS. In general, the relationships between the determinants and QoL were similar across the dementia subtypes. Aspects of QoL differed by dementia subtype. Residents with frontotemporal dementia showed less negative emotions, accepted more help and experienced better quality of relationships with professional caregivers, had a more positive self-image, felt more comfortable in the nursing home environment, and experienced lower quality of social relationships. Conclusions: Considering the high rates of NPS and PDU in YOD residents and their negative associations with QoL, we recommend emphasizing services to manage and reduce NPS and PDU in nursing home residents with YOD. Furthermore, our findings suggest accounting for differences in aspects of QoL by dementia subtype to address specific needs and thereby improve QoL.

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“…Another important difference is that onset was defined in some studies as initial clinical evaluation, 4 and we chose to examine time from symptom onset because there is often a significant delay in making the clinical diagnosis of FTD and atypical presentations of AD. 28 Another issue is the way in which occupation was ranked. While some chose to dichotomize occupation (high vs low), 4 we chose to look at the difference between levels of occupation and we found a protective effect at every level.…”

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confidence: 99%

Occupational attainment influences survival in autopsy-confirmed frontotemporal degeneration

et al. 2015

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Objective: To examine the influence of occupational attainment and education on survival in autopsyconfirmed cases of frontotemporal lobar degeneration (FTLD) and Alzheimer disease (AD).Methods: We performed a retrospective chart review of 83 demographically matched, autopsyconfirmed FTLD (n 5 34) and AD (n 5 49) cases. Each patient's primary occupation was classified and ranked. Level of education was recorded in years. Survival was defined as time from symptom onset until death. Linear regression was used to test for associations among occupational attainment, education, and patient survival.Results: Median survival was 81 months for FTLD and 95 months for AD. Years of education and occupational attainment were similar for both groups. We found that higher occupational attainment was associated with longer survival in FTLD but not AD. Cognitive reserve (CR) posits that a person develops cognitive strategies and neural connections over the course of a lifetime through experiences such as education, occupation, and mental engagement. Conclusions:

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Time to diagnosis in young-onset dementia as compared with late-onset dementia

Abstract: There is a need to raise special awareness of YOD to facilitate a timely diagnosis.

Cited by 218 publications

References 50 publications

Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

The Determinants of Quality of Life of Nursing Home Residents with Young-Onset Dementia and the Differences between Dementia Subtypes

Occupational attainment influences survival in autopsy-confirmed frontotemporal degeneration

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