Incipient symptoms of Alzheimer's disease and effect of education on the onset age: A study of 155 Taiwanese patients

Objective: To study the incipient symptoms of patients with Alzheimer's disease (AD) and relating them to the onset age of AD and the educational level. Method: The families of the AD patients provided information regarding incipient symptoms through directed questioning. The patients came from a special clinic of behavioral neurology in an 800-bed referral medical center. Result: A total of 155 AD patients were surveyed, including 92 females and 63 males (F/M ratio, 1.46). The mean age of onset of AD was 69 years (SD, 8 years, ranging from 48 to 88 years). Memory impairment was the most common incipient symptom (74%), followed by delusion (8%), topographical disorientation (7%), apraxia or dysexecutive (6%), and personality change (5%). Analysis of variance showed that the patients with delusion as incipient symptom were older at onset (p=0.03). Further analysis indicated that the onset age was not related to education level (p=0.731), gender (p=0.582) and their interaction (p=0.118). Concluions: It deserves attention that AD patients may initially seek treatment for symptoms other than amnesia. Elderly patients with recent onset of delusion, disorientation, apraxia or personality change should be followed up closely to rule out the possibility of AD. However, educational level was not related to the onset age of AD in this patient group.