Am J Psychiatry 1992; 149:1023-1027
Copyright © 1992 by American Psychiatric Association
Are there clinical differences between familial and nonfamilial Alzheimer's disease?
DJ Luchins, D Cohen, P Hanrahan, C Eisdorfer, G Paveza, JW Ashford, P Gorelick, R Hirschman, S Freels and P Levy
Department of Psychiatry, University of Chicago, IL 60637.
OBJECTIVE: The purpose of the study was to determine whether there are
differences in clinical characteristics in two groups of patients with
Alzheimer's disease, those reported to have a family history of dementia
and those without a family history of dementia. METHOD: Using a data set
from an Alzheimer's disease patient registry, funded as part of a National
Institute on Aging cooperative agreement, the authors made comparisons of
sociodemographic and clinical variables in a group of 462 patients with
Alzheimer's disease, 172 reported to have at least one first-degree
relative with dementia and 290 classified with no family history. RESULTS:
Patients with a presumptive family history differed from those without a
family history in two ways: the course of dementia was described as having
a fast rather than a slow progression from onset of symptoms to diagnosis,
and caregivers reported a higher prevalence of family history of
psychiatric disorders. There were no significant differences in age at
onset, duration, female gender, aphasia and apraxia, handedness, family
history of Down's syndrome, or number of children, brothers, and sisters.
CONCLUSIONS: The association of faster course and family history of
psychiatric disorders in the patients with a family history of dementia is
consistent with the hypothesis of heterogeneity, but the overall results
could also be explained by a genetic-environmental model of Alzheimer's
disease.
