Earlier onset of Alzheimer disease symptoms in latino individuals compared with anglo individuals.

BACKGROUND Latino individuals are the largest minority group and the fastest growing population group in the United States, yet there are few studies comparing the clinical features of Alzheimer disease (AD) in this population with those found in Anglo (white non-Latino) patients. OBJECTIVE To compare the age at AD symptom onset in Latino and Anglo individuals. DESIGN Cross-sectional assessment using standardized methods to collect and compare age at AD symptom onset, demographic variables, and medical variables. SETTING Five National Institute on Aging-sponsored Alzheimer's Disease Centers with experience evaluating Spanish-speaking individuals. PATIENTS We evaluated 119 Latino and 55 Anglo patients who had a diagnosis of AD. MAIN OUTCOME MEASURE Age at symptom onset. RESULTS After adjusting for center, sex, and years of education, Latino patients had a mean age at symptom onset 6.8 years earlier (95% confidence interval, 3.5-10.3 years earlier) than Anglo patients. CONCLUSIONS An earlier age at symptom onset suggests that US mainland Latino individuals may experience an increased burden of AD compared with Anglo individuals. The basis for the younger age at symptom onset remains obscure.

[1]  Y. Stern,et al.  Literacy and cognitive change among ethnically diverse elders , 2004 .

[2]  R. Green,et al.  Depression as a risk factor for Alzheimer disease: the MIRAGE Study. , 2003, Archives of neurology.

[3]  W. Jagust,et al.  Prevalence of Dementia in Older Latinos: The Influence of Type 2 Diabetes Mellitus, Stroke and Genetic Factors , 2003, Journal of the American Geriatrics Society.

[4]  R. Mohs,et al.  Consortium to establish a registry for Alzheimer's disease (CERAD) clinical and neuropsychological assessment of Alzheimer's disease. , 2002, Psychopharmacology bulletin.

[5]  Y. Stern,et al.  Reading level attenuates differences in neuropsychological test performance between African American and White elders , 2002, Journal of the International Neuropsychological Society.

[6]  R. Costa,et al.  Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan , 2001, Neurology.

[7]  A. Minagar,et al.  Cerebral ventricles are smaller in Hispanic than non-Hispanic patients with Alzheimer’s disease , 2000, Neurology.

[8]  S. Sevush,et al.  Apolipoprotein-E ɛ4 Allele Frequency and Conferred Risk for Cuban Americans With Alzheimer's Disease , 2000 .

[9]  K. Tucker,et al.  Prevalence and correlates of depressive symptoms among Hispanic elders in Massachusetts. , 2000, The journals of gerontology. Series B, Psychological sciences and social sciences.

[10]  C. Magai,et al.  Racial differences in neuropsychiatric symptoms among dementia outpatients. , 1999, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[11]  O. Lopez,et al.  [The Neuropsychiatric Inventory. Psychometric properties of its adaptation into Spanish]. , 1999, Revista de neurologia.

[12]  R. Mayeux,et al.  Rates of dementia in three ethnoracial groups , 1999, International journal of geriatric psychiatry.

[13]  P. S. St George-Hyslop,et al.  A cross-ethnic analysis of risk factors for AD in white Hispanics and white non-Hispanics , 1999, Neurology.

[14]  D. Jolley,et al.  Cost benefits of a medically supervised day treatment program for patients with Alzheimer's disease and other forms of dementia , 1989 .

[15]  Y. Stern,et al.  Normative data for a brief neuropsychological battery administered to English- and Spanish-speaking community-dwelling elders , 1998, Journal of the International Neuropsychological Society.

[16]  K. Marder,et al.  The APOE- (cid:101) 4 Allele and the Risk of Alzheimer Disease Among African Americans, Whites, and Hispanics , 2001 .

[17]  R. Lewis,et al.  Dementia in older minority populations. Issues of prevalence, diagnosis, and treatment. , 1998, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[18]  J. Haines,et al.  Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. , 1997, JAMA.

[19]  J. Haines,et al.  Effects of Age, Sex, and Ethnicity on the Association Between Apolipoprotein E Genotype and Alzheimer Disease: A Meta-analysis , 1997 .

[20]  R. Doody,et al.  Incidence and prevalence of dementia in a multiethnic cohort of municipal retirees , 1997, Neurology.

[21]  J. Cummings,et al.  The Neuropsychiatric Inventory , 1997, Neurology.

[22]  D. Espino,et al.  A SPANISH VERSION OF THE GERIATRIC DEPRESSION SCALE IN MEXICAN‐AMERICAN ELDERS , 1997, International journal of geriatric psychiatry.

[23]  P. S. St George-Hyslop,et al.  Alzheimer's disease , 1996, Neurology.

[24]  C. Clark,et al.  Performance of the Dementia Severity Rating Scale: A Caregiver Questionnaire for Rating Severity in Alzheimer Disease , 1996, Alzheimer disease and associated disorders.

[25]  M. Albert,et al.  A standardized technique for establishing onset and duration of symptoms of Alzheimer's disease. , 1995, Archives of neurology.

[26]  B. Tycko,et al.  Apolipoprotein E and alzheimer's disease: Ethnic variation in genotypic risks , 1995, Annals of neurology.

[27]  A. Ardila,et al.  Neuropsychological Evaluation of the Spanish Speaker , 1994, Critical Issues in Neuropsychology.

[28]  C. Mulrow,et al.  Functional Status of Mexican American Nursing Home Residents , 1994, Journal of the American Geriatrics Society.

[29]  B. Tycko,et al.  The apolipoprotein ε4 allele in patients with Alzheimer's disease , 1993, Annals of neurology.

[30]  Eliseo J. Perez-Stable,et al.  Development of a Short Acculturation Scale for Hispanics , 1987 .

[31]  J. Yesavage,et al.  Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. , 1986 .

[32]  Carmela G. Lacayo.  A National Study To Assess the Service Needs of the Hispanic Elderly. Final Report. , 1980 .

[33]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[34]  B. Tycko,et al.  Familial Alzheimer disease among Caribbean Hispanics: a reexamination of its association with APOE. , 2002, Archives of neurology.

[35]  S. Sevush,et al.  Apolipoprotein-E epsilon 4 allele frequency and conferred risk for Cuban Americans with Alzheimer's disease. , 2000, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.