{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:39:12Z","timestamp":1789738752009,"version":"4.0.1"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2009,4,1]],"date-time":"2009-04-01T00:00:00Z","timestamp":1238544000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:sec id=\"S0033291709005492_sec_001\"><jats:title>Background<\/jats:title><jats:p>We aimed to compare the rate of cognitive decline in patients with early and late onset Alzheimer's disease (AD) and to investigate the potentially modifying influence of the apolipoprotein E (APOE) genotype.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291709005492_sec_a002\"><jats:title>Method<\/jats:title><jats:p>We included 99 patients with early onset AD (age \u2a7d65 years) and 192 patients with late onset AD (age &gt;65 years) who had at least two scores on the Mini-Mental State Examination (MMSE) (range 2\u201314) obtained at least 1 year apart. Linear mixed models were performed to investigate the rate of cognitive decline dependent on age at onset (AAO) and APOE genotype.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291709005492_sec_a003\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The mean (<jats:sc>s.d<\/jats:sc>.) age for patients with early onset AD was 57.7 (4.5) years, and 74.5 (5.1) years for patients with late onset AD. AAO was not associated with baseline MMSE [\u03b2 (<jats:sc>s.e<\/jats:sc>.)=0.8 (0.5), <jats:italic>p<\/jats:italic>=0.14]. However, patients with early onset showed a faster decline on the MMSE [\u03b2 (<jats:sc>s.e<\/jats:sc>.)=2.4 (0.1) points\/year] than those with late onset [\u03b2 (<jats:sc>s.e<\/jats:sc>.)=1.7 (0.1) points\/year, <jats:italic>p<\/jats:italic>=0.00]. After stratification according to APOE genotype, APOE \u03b54 non-carriers with early onset showed faster cognitive decline than non-carriers with late onset [2.4 (0.3) <jats:italic>v<\/jats:italic>. 1.3 (0.3) points\/year, <jats:italic>p<\/jats:italic>=0.01]. In APOE \u03b54 carriers, no difference in rate of cognitive decline was found between patients with early and late onset [\u03b2 (<jats:sc>s.e<\/jats:sc>.)=0.2 (0.2), <jats:italic>p<\/jats:italic>=0.47].<\/jats:p><\/jats:sec><jats:sec id=\"S0033291709005492_sec_a004\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>Patients with early onset AD show more rapid cognitive decline than patients with late onset, suggesting that early onset AD follows a more aggressive course. Furthermore, this effect seems to be most prominent in patients with early onset who do not carry the genetic APOE \u03b54 risk factor for AD.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291709005492","type":"journal-article","created":{"date-parts":[[2009,4,1]],"date-time":"2009-04-01T04:29:30Z","timestamp":1238560170000},"page":"1907-1911","source":"Crossref","is-referenced-by-count":98,"title":["Most rapid cognitive decline in APOE \u03b54 negative Alzheimer's disease with early onset"],"prefix":"10.1017","volume":"39","author":[{"given":"A. E.","family":"van der Vlies","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. L. G. E.","family":"Koedam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. A. L.","family":"Pijnenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W. R.","family":"Twisk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Scheltens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. M.","family":"van der Flier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2009,4,1]]},"reference":[{"key":"S0033291709005492_ref022","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410410510"},{"key":"S0033291709005492_ref021","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000311446.61861.e3"},{"key":"S0033291709005492_ref019","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050351"},{"key":"S0033291709005492_ref018","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1983.04050030037006"},{"key":"S0033291709005492_ref004","first-page":"S10","article-title":"Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. 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Neurologic Diseases in the Elderly Research Group","volume":"54","author":"Lobo","year":"2000","journal-title":"Neurology"},{"key":"S0033291709005492_ref017","doi-asserted-by":"publisher","DOI":"10.1159\/000054786"},{"key":"S0033291709005492_ref007","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1987.tb01315.x"},{"key":"S0033291709005492_ref015","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050151"},{"key":"S0033291709005492_ref020","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.55.7.964"},{"key":"S0033291709005492_ref005","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410370509"},{"key":"S0033291709005492_ref006","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.6.691"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291709005492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T06:02:28Z","timestamp":1556604148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291709005492\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4,1]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["S0033291709005492"],"URL":"https:\/\/doi.org\/10.1017\/s0033291709005492","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4,1]]}}}