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Early-Onset Alzheimer’s Disease Is Associated With Greater Pathologic Burden

Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, gamarchall{at}partners.org

Lynn A. Fairbanks, PhD

Psychiatry and Biobehavioral Neuroscience, David Geffen School of Medicine, University of California, Los Angeles

Sibel Tekin, MD

Florham Park, New Jersey

Harry V. Vinters, MD

Department of Neurology, Pathology and Laboratory Medicine, Neuropathology, David Geffen School of Medicine, University of California, Los Angeles

Jeffrey L. Cummings, MD

Department of Neurology, Psychiatry and Biobehavioral Neuroscience, David Geffen School of Medicine, University of California, Los Angeles

Two subtypes of Alzheimer’s disease (AD) have been commonly identified: early- and late-onset forms. Previous studies suggest that early-onset AD patients have more neuritic plaques (NPs) and neurofibrillary tangles (NFTs). In the current study, NP and NFT counts were performed for 8 brain regions in 25 subjects with definite AD. A repeated-measures analysis of variance of mean regional NP and NFT counts for early- and late-onset groups was performed. A significant between-subject effect indicating greater overall NP and NFT burden in the early-onset group was observed (NP: F = 6.8, df = 1, P = .015; NFT: F = 7.5, df = 1, P = .012). This analysis supports the hypothesis that early-onset AD is associated with greater pathologic burden than late-onset AD. This suggests that late-onset AD patients have less cognitive reserve than early-onset patients and require fewer pathologic changes to exhibit cognitive deterioration.

Key Words: Alzheimer’s disease • early onset • late onset • pathology • neuritic plaques • neurofibrillary tangles

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