NEUROLOGY 1985;35:453
© 1985 American Academy of Neurology
Heterogeneity in dementia of the Alzheimer type
Evidence of subgroups
Richard Mayeux, MD,
Yaakov Stern, PhD and
Susan Spanton
Department of Neurology, Columbia University, College of Physicians and Surgeons, and the Presbyterian Hospital in the City of New York
We reviewed records of 121 consecutive patients with dementia of the Alzheimer type. Patients with myoclonus or extrapyramidal signs had greater intellectual decline and functional impairment in daily activities. Among patients studied over 4 years, there were four groups: benignlittle to no progression; myoclonicsevere intellectual decline and frequent mutism after younger onset; extrapyramidalsevere intellectual and functional decline and frequent psychotic symptoms; typicala gradual progression of intellectual and functional decline, but without other distinguishing features. Except for the group with myoclonus, no subgroup was segregated by age at onset or other demographic variables. This study suggests that dementia of the Alzheimer type is heterogeneous, and that certain clinical manifestations may be useful in predicting outcome.
Address correspondence and reprint requests to Dr. Mayeux, 710 West 168th Street, Neurological Institute. New York. NY 10032.
Supported in part by the Charles S. Robertson Memorial Gift for Alzheimer's Disease from the Banbury Fund and a federal grant (AG 02802) to Dr. Mayeux. Data were stored and analyzed on a CLINFO system (NIH RK00645).
Presented in part at the thirty-sixth annual meeting of the American Academy of Neuroloky, Boston. MA, April 1984.
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J. C. Morris, M. Drazner, K. Fulling, E. A. Grant, and J. Goldring
Clinical and Pathological Aspects of Parkinsonism in Alzheimer's Disease: A Role for Extranigral Factors?
Arch Neurol,
June 1, 1989;
46(6):
651 - 657.
[Abstract]
[PDF]
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D. P. Dastoor and M. G. Cole
Age related patterns of decline in dementia as measured by the hierarchic dementia scale (HDS)
American Journal of Alzheimer's Disease and Other Dementias,
November 1, 1988;
3(6):
29 - 35.
[PDF]
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R. P. Friedland, E. Koss, J. V. Haxby, C. L. Grady, J. Luxenberg, M. B. Schapiro, and J. Kaye
Alzheimer Disease: Clinical and Biological Heterogeneity
Ann Intern Med,
August 15, 1988;
109(4):
298 - 311.
[Abstract]
[PDF]
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J. Botwinick, M. Storandt, L. Berg, and S. Boland
Senile Dementia of the Alzheimer Type: Subject Attrition and Testability in Research
Arch Neurol,
May 1, 1988;
45(5):
493 - 496.
[Abstract]
[PDF]
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J. R. Atack, M. F. Beal, C. May, J. A. Kaye, M. F. Mazurek, A. D. Kay, and S. I. Rapoport
Cerebrospinal Fluid Somatostatin and Neuropeptide Y: Concentrations in Aging and in Dementia of the Alzheimer Type With and Without Extrapyramidal Signs
Arch Neurol,
March 1, 1988;
45(3):
269 - 274.
[Abstract]
[PDF]
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E. LaBarge, L. S. Rosenman, K. Leavitt, and T. Cristiani
Counseling Clients with Mild Senile Dementia of the Alzheimer's Type: A Pilot Study
Neurorehabil Neural Repair,
January 1, 1988;
2(4):
167 - 173.
[Abstract]
[PDF]
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R. J. KIERNAN, J. MUELLER, J. W. LANGSTON, and C. VAN DYKE
The Neurobehavioral Cognitive Status Examination: A Brief But Differentiated Approach to Cognitive Assessment
Ann Intern Med,
October 1, 1987;
107(4):
481 - 485.
[Abstract]
[PDF]
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F. J. Huff, F. Boller, F. Lucchelli, R. Querriera, J. Beyer, and S. Belle
The Neurologic Examination in Patients With Probable Alzheimer's Disease
Arch Neurol,
September 1, 1987;
44(9):
929 - 932.
[Abstract]
[PDF]
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W. Bondareff, C. Q. Mountjoy, M. Roth, M. N. Rossor, L. L. Iversen, and G. P. Reynolds
Age and Histopathologic Heterogeneity in Alzheimer's Disease: Evidence for Subtypes
Arch Gen Psychiatry,
May 1, 1987;
44(5):
412 - 417.
[Abstract]
[PDF]
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L. Volicer, B. Seltzer, Y. Rheaume, K. Fabiszewski, L. Herz, R. Shapiro, and P. Innis
Progression of Alzheimer-Type Dementia in Institutionalized Patients: A Cross-Sectional Study
Journal of Applied Gerontology,
March 1, 1987;
6(1):
83 - 94.
[Abstract]
[PDF]
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J. Botwinick, M. Storandt, and L. Berg
A Longitudinal, Behavioral Study of Senile Dementia of the Alzheimer Type
Arch Neurol,
November 1, 1986;
43(11):
1124 - 1127.
[Abstract]
[PDF]
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J. Leverenz and S. M. Sumi
Parkinson's Disease in Patients With Alzheimer's Disease
Arch Neurol,
July 1, 1986;
43(7):
662 - 664.
[Abstract]
[PDF]
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M. Schweber
Etiologic theories of Alzheimer's disease
American Journal of Alzheimer's Disease and Other Dementias,
January 1, 1986;
1(1):
24 - 31.
[Abstract]
[PDF]
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