Abstract
Alzheimer disease (AD) is a devastating neurodegenerative disease affecting 1 in 68 in the population. An arbitrary cutoff 65 years as the age of onset to distinguish between early- and late-onset AD has been proposed and has been used in the literature for decades. As the majority of patients develop AD after 65 years of age, most clinical trials address this population. While the early-onset cases represent only 1% to 6% of AD cases, this population is the active working subset and thus contributes to a higher public health burden per individual, and early-onset cases are the most devastating at the level of the individual and their families. In this review, we compare and contrast the clinical, neuropsychological, imaging, genetic, biomarker, and pathological features of these two arbitrary groups. Finally, we discuss the ethical dilemma of non-abandonment and justice as it pertains to exclusion of the early-onset AD patients from clinical trials.
Highlights
Alzheimer disease (AD) is a devastating neurodegenerative disease affecting 1 in 68 in the population
early-onset Alzheimer disease (EOAD) and late-onset Alzheimer disease (LOAD) are distinguished on the basis of age of onset (AOO) alone
While there is a consensus that LOAD appears to have a more predominant impairment of memory, it remains unclear whether language, visuospatial abilities, and praxis are more affected or preserved in EOAD compared with LOAD [9]
Summary
Alzheimer disease (AD) is a devastating neurodegenerative disease affecting 1 in 68 in the population. The age of disease onset of patients with AD ranged from 50 to 99 in most studies but included subjects with AOO as low as 41 years in a few.
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