1. CHARACTERISTICS OF EARLY ONSET DEMENTIA IN A HOSPITAL SETTING FROM ROMANIA
M. M. Dumitru¹∙², V.Chirita¹∙², R.Chirita¹∙²
“Socola” Psychiatric Hospital, Iasi, Romania
“Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
Introduction
TABLE 1. General Characteristics of Early-onset Dementia and Late-onset Dementia
Early-onset Dementia
Late-onset Dementia P N 81
269
Men 43
110
0.001
Age of onset (years)
54.7±10
77.8±7
Current MMSE score
18.4±7.3
17.2±6.2
0.02
Education level*
Primary
48 (59.3%)
193 (71.7%)
High school
15 (18.5%)
50 (18.6%)
Graduate education
18 (22.2%)
26 (9.7%)
Residence
Home (married or with family)
56 (69.1%)
132 (49.1%)
Home, alone
14 (17.3%)
97 (36.1%)
Nursing home
11 (13.6%)
40 (14.8%)
Etiology
Alzheimer’s disease
128 (47.6%)
Vascular dementia
43 (16%)
Fronto-temporal dementia
8 (9.9%)
7 (2.6%)
Alcohol-related dementia
13 (16.1%)
11 (4.1%)
Traumatic brain injury
5 (6.2%)
2 (0.7%)
Huntington’s disease
4 (4.9%)
Parkinson’s disease
2 (2.5%)
16 (5.9%)
AD+cerebrovascular disease
22 (8.2%)
Other causes
31 (11.5%)
Dementia represents a true flagellum of the contemporary society, this pathology reducing life expectancy and quality of life dramatically for the elderly(1). It is probably the most important of the degenerative diseases due to its frequent occurrence and devastating nature. Diagnosis of early onset dementia (EOD), defined as the onset of dementia before the age of 65 years, is frequently missed in these younger patients, as it can be caused by a great number of etiologies and presents with a variety of symptoms.
Objective
The main objective of this study was to describe the frequency, clinical characteristics and etiology of EOD and to compare with late onset dementia (LOD), and the
second objective  was to compare EOD with LOD.
Materials and Methods
The study we included all patients with dementia defined according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, referred to the “Socola” Psychiatric Hospital between In the EOD group were included patients age less than 65 years, and the older patients were included in the late-onset dementia (LOD) group. Cognitive functioning was assessed  with the Mini Mental State Examination (MMSE). Dementia was diagnosed and classified according to common criteria: fronto-temporal lobar degeneration (FTD),(2) alcohol-related dementia (ARD), (3) and Parkinson’s disease (PD) dementia.(4) The EOD and LOD groups were compared in terms of demographic features and the causes and severity of dementia. The categorical variables were compared with x² test and continuous variables, with t-test. A P value of less than 0.05 was considered significant. Analyses were performed using SPSS statistical software.
Results
A number of 350 patients (190 women) were included and 81 were classified as EOD. The sex ratio was 1.18, but women were frequent in LOD (p=0.03). Patients with EOD were more frequently (p=0.003), they had a higher education than LOD, but a lower educational level than the general population. Patients with EOD were more likely to live at home and less likely to live alone.
The MMSE did not differ between EOD and LOD. The most frequent causes of dementia were Alzheimer’s disease (28.4%) and vascular disease (19.8%). Alcohol-related dementia (16.1%), frontotemporal dementia (9.9%) and traumatic brain injury (6.2%) were significantly more frequent (p<0.005) in EOD group than in LOD group.
References
1. J. P. Browne, Individual quality of life in the healthy elderly. Quality of Life Research , 1994, Volume 3, Issue 4,
2. Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology. 1998;51:1546–1554.
3. Oslin D, Atkinson E, Smith D, et al. Alcohol related dementia: proposed clinical criteria. Int J Geriatr Psychiatry. 1998;13:203–212.
4. Emre M, Aarsland D, Brown R, et al. Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord. 2007;22:1689–1707.
Conclusions
EOD is characterized by specific characteristics and different causes. EOD represented approximately a quarter of patients with dementia. Many of patients with EOD were living at home, the sex ratio was close to 1, had a higher level than LOD patients and had a similar overall dementia severity. Alzheimer’s disease, vascular disease, alcohol-related dementia , fronto-temporal dementia and traumatic brain injury were the principal causes of dementia in EOD.
Correspondence to: Maria Magdalena Dumitru, “Socola” Psychiatric Hospital, Road Bucium, No.36, Iasi, Romania,
No potential conflict of interest