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Duration of preclinical, prodromal, and dementia stages of Alzheimer's disease in relation to age, sex, and APOE genotype
Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Statistical Science, University College London, London, UK.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centrum Limburg, Maastricht University, Maastricht, The Netherlands.
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2019 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 15, no 7, p. 888-898Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: We estimated the age-specific duration of the preclinical, prodromal, and dementia stages of Alzheimer's disease (AD) and the influence of sex, setting, apolipoprotein E (APOE) genotype, and cerebrospinal fluid tau on disease duration.

METHODS: We performed multistate modeling in a combined sample of 6 cohorts (n = 3268) with death as the end stage and estimated the preclinical, prodromal, and dementia stage duration.

RESULTS: The overall AD duration varied between 24 years (age 60) and 15 years (age 80). For individuals presenting with preclinical AD, age 70, the estimated preclinical AD duration was 10 years, prodromal AD 4 years, and dementia 6 years. Male sex, clinical setting, APOE ε4 allele carriership, and abnormal cerebrospinal fluid tau were associated with a shorter duration, and these effects depended on disease stage.

DISCUSSION: Estimates of AD disease duration become more accurate if age, sex, setting, APOE, and cerebrospinal fluid tau are taken into account. This will be relevant for clinical practice and trial design.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 15, no 7, p. 888-898
Keywords [en]
APOE, Alzheimer's disease, Clinical setting, Dementia, Disease duration, Multistate model, Preclinical, Prodromal, Progression
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-75631DOI: 10.1016/j.jalz.2019.04.001ISI: 000475846300004PubMedID: 31164314Scopus ID: 2-s2.0-85066298869OAI: oai:DiVA.org:oru-75631DiVA, id: diva2:1344249
Note

Funding Agency:

NIA NIH HHS

Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-20Bibliographically approved

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Freund-Levi, Yvonne

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