Disease Course Varies According to Age and Symptom Length in Alzheimer's Disease

Josephine Barnes, Jonathan W. Bartlett, David A. Wolk, Wiesje M. Van Der Flier, Chris Frost

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)


Health-care professionals, patients, and families seek as much information as possible about prognosis for patients with Alzheimer's disease (AD); however, we do not yet have a robust understanding of how demographic factors predict prognosis. We evaluated associations between age at presentation, age of onset, and symptom length with cognitive decline as measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating sum-of-boxes (CDR-SOB) in a large dataset of AD patients. Age at presentation was associated with post-presentation decline in MMSE (p < 0.001), with younger patients showing faster decline. There was little evidence of an association with change in CDR-SOB. Symptom length, rather than age, was the strongest predictor of MMSE and CDR-SOB at presentation, with increasing symptom length associated with worse outcomes. The evidence that younger AD patients have a more aggressive disease course implies that early diagnosis is essential.

Original languageEnglish
Pages (from-to)631-642
Number of pages12
JournalJournal of Alzheimer's Disease
Issue number2
Publication statusPublished - 1 Jan 2018


  • Age factors
  • Alzheimer's disease
  • age of onset
  • cognition
  • cognitive decline

Cite this