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P2‐318: THE EFFECT OF APOE‐ε4 ON THE TRAJECTORY OF ALZHEIMER'S DISEASE RELATED COGNITIVE DECLINE IN CHINESE POPULATION
Author(s) -
Jia Jianping,
Xu Hui,
Li Fangyu,
Feng Xueyan
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.1008
Subject(s) - apolipoprotein e , longitudinal study , cognitive decline , medicine , disease , cognition , allele , risk factor , alzheimer's disease , prospective cohort study , age of onset , psychology , oncology , gerontology , demography , dementia , psychiatry , biology , pathology , genetics , gene , sociology
Background: Patients with dementia, particularly Alzheimer’s disease (AD), are at an increased risk of developing epilepsy. However, the extent of this increased risk has been disputed and remains unclear. We measured the prevalence of epilepsy in a cohort of patients with AD recruited from a memory clinic in secondary care to identify which patients are at a risk of epilepsy, the clinical features of these seizures and the stage of disease at which seizures occur Methods:Patients with a diagnosis of probable AD dementia were recruited from a regional memory clinic. Interviews were conducted with the patient and a reliable informant using a structured proforma designed for this purpose. Using their responses to questions regarding clinical features of epilepsy, patients were categorised into three groups: epilepsy probable, epilepsy possible, or no clinical suspicion of epilepsy. Dementia diagnoses were confirmed using established research criteria. Cognitive function was measured using the Addenbrooke’s Cognitive Examination Version-III (ACE-III). Results: 102 patients were recruited to the study. 12 patients (11.7%) were categorised to the epilepsy probable group and 16 (15.7%) patients to the epilepsy possible group. This group was not significantly different to those in whom there was no suspicion of epilepsy, in terms of age, gender, or duration of memory symptoms. However, there was a significant difference in the Clinical Dementia Rating (CDR) sum of boxes score between those with epilepsy and thosewithout. In the epilepsy probable group, 9 patients (75%) experienced focal impaired awareness / focal behavioural arrest seizures; 2 patients (16.67%) experienced generalised tonicclonic seizures. A range of further seizure features were also seen. The mean duration from onset of memory impairment to seizure onset in this group was 16.4 months (range 0 to 36). Conclusions:Patientswho experience epilepsy as a result of their dementia are demographically and cognitively similar to those that do not have epilepsy, but may experience a broader range of cognitive impairments and increased care needs as evidenced by elevated CDR scores. In our cohort, patients with epilepsy were likely to have experienced a first seizure within 18 months of developing memory symptoms.