Presence of parieto‐temporal symptomatology distinguishes early and late onset Alzheimer's disease

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Abstract
Thirty‐one patients with early onset Alzheimer's disease (EAD) and 44 with late onset Alzheimer's disease (LAD) were examined with regard to symptoms reflecting disturbances in various brain regions, ie frontal, parietal and subcortical symptoms. Clinical vascular factors were recorded. The albumin ratio (CSF albumin/serum albumin) was used as a measure of the blood‐brain barrier (BBB) function. Parietal symptoms were more common in EAD than in LAD, both among mildly demented patients (60% in EAD, 10% in LAD; p<0.01) and among moderately demented patients (93% in EAD, 58% in LAD; p<0.01). Among moderately and severely demented patients, predominance parietal symptoms was more common in EAD (93%) than in LAD (26%) (p<0.01). Patients with predominant parietal symptoms had significantly lower age at onset, absence of concomitant diseases, and normal BBB function, and we suggest that they constitute the classical AD group. A symptom profile without parietal predominance was found to be associated with higher age at onset, presence of clinical vascular factors and impaired BBB function, suggesting that age‐related and/or vascular factors may influence the symptomatology in this group.