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 "APOE4 predicted mortality for PD and LBD" 
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Post "APOE4 predicted mortality for PD and LBD"
This is a study of survival time for subjects seen at Emory over a 15 year period with various neurological diseases, including LBD. In this article, LBD stands for "Lewy body disease." But since the article also refers to Parkinson's disease (which is a Lewy body disease), we can assume that LBD actually refers to Lewy body dementia. The number of patients seen with LBD was surprisingly small (64).

Comparing ALS, AD, PD, mild cognitive impairment, frontotemporal dementia, and LBD, ALS has a significantly shorter survival time (of 2-3 years from any starting point -- time of onset of symptoms, time of referral, or time of diagnosis).

The presence of the apolipoprotein E4 (APOE4) allele "predicted mortality for PD and LBD" while a "lower initial MMSE score was associated with higher mortality for probable AD, PD, and MCI."

Another finding was that "Non-whites had 20% lower mortality rates than whites for all dementias combined, adjusting for education. ... The reasons for the improved survival in non-whites versus whites among patients with neurodegenerative disease are not known."

Robin



Neuroepidemiology. 2010 Apr 8;35(1):28-35. [Epub ahead of print]

Factors Affecting Survival of Patients with Neurodegenerative Disease.

Steenland K, Macneil J, Seals R, Levey A.
Department of Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, GA.

Abstract
Background: Survival varies widely among different neurodegenerative diseases. Data on the role of the Mini Mental State Examination (MMSE) and apolipoprotein E (APOE) in survival are sparse except for Alzheimer's disease (AD).

Methods: We studied mortality of 3,581 patients in an academic clinic from 1993 to 2004. Average follow-up was 4.1 years.

We studied patients with amyotrophic lateral sclerosis (ALS) (n = 174), possible AD (n = 206), probable AD (n = 1,175), Parkinson's disease (PD) (n = 661), mild cognitive impairment (MCI) (n = 357), frontotemporal dementia (FTD) (n = 94), Lewy body disease (LBD) (n = 64), and controls (n = 850).

We compared patients' mortality to the US population and to controls.

Results: Mortality ranged from 7% for controls to 58% for ALS patients.

The median survival times from initial visit for PD, FTD, probable AD, possible AD, LBD, and ALS were 8.9, 7.0, 5.9, 5.6, 5.3, and 2.7 years, respectively.

Mortality rate ratios comparing each disease to controls were 39.43, 7.25, 3.70, 3.51, 2.47, 2.73, and 1.61 for ALS, FTD, LBD, PD, probable AD, possible AD, and MCI, respectively.

A lower initial MMSE score was associated with higher mortality for probable AD, PD, and MCI, while APOE4 predicted mortality for PD and LBD.

Non-whites had 20% lower mortality rates than whites for all dementias combined, adjusting for education.

Conclusions: All neurologic diseases, including MCI, had increased mortality versus controls. A lower MMSE score and APOE4 presence predicted higher mortality for some patient groups.

Copyright © 2010 S. Karger AG, Basel.

PubMed ID#: 20389122 (see pubmed.gov)


Wed Apr 21, 2010 10:38 pm
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