Signs and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016

2.50
Hdl Handle:
http://hdl.handle.net/10547/622211
Title:
Signs and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016
Authors:
Bature, Fidelia; Guinn, Barbara-Ann; Pang, Dong; Pappas, Yannis ( 0000-0003-3087-860X )
Abstract:
Objective Late diagnosis of Alzheimer’s disease (AD) may be due to diagnostic uncertainties. We aimed to determine the sequence and timing of the appearance of established early signs and symptoms in people who are subsequently diagnosed with AD. Methods We used systematic review methodology to investigate the existing literature. Articles were reviewed in May 2016, using the following databases: MEDLINE, PsycINFO, CINAHL, British Nursing Index, PubMed central and the Cochrane library, with no language restriction. Data from the included articles were extracted independently by two authors and quality assessment was undertaken with the quality assessment and diagnostic accuracy tool-2 (QUADAS tool-2 quality assessment tool). Results We found that depression and cognitive impairment were the first symptoms to appear in 98.5% and 99.1% of individuals in a study with late-onset AD (LOAD) and 9% and 80%, respectively, in early-onset AD (EOAD). Memory loss presented early and was experienced 12 years before the clinically defined AD dementia in the LOAD. However, the rapidly progressive late-onset AD presented predominantly with 35 non-established focal symptoms and signs including myoclonus (75%), disturbed gait (66%) and rigidity. These were misdiagnosed as symptoms of Creutzfeldt-Jacob disease (CJD) in all the cases. The participant with the lowest mini-mental state examination score of 25 remained stable for 2 years, which is consistent with the score of the healthy family members. Conclusions The findings of this review suggest that neurological and depressive behaviours are an early occurrence in EOAD with depressive and cognitive symptoms in the measure of semantic memory and conceptual formation in LOAD. Misdiagnosis of rapidly progressive AD as CJD and the familial memory score can be confounding factors while establishing a diagnosis. However, the study was limited by the fact that each one of the findings was based on a single study. * Alzheimer's disease (AD) * systematic scoping review * early signs and symptoms * mild cognitive impairment (MCI) * early stage of AD
Affiliation:
University of Bedfordshire
Citation:
Bature F, Guinn B, Pang D, Pappas Y (2017) 'Signs and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016', BMJ Open, 7 (8), pp.e015746.
Publisher:
British Medical Journal
Journal:
BMJ Open
Issue Date:
28-Aug-2017
URI:
http://hdl.handle.net/10547/622211
DOI:
dx.doi.org/10.1136/bmjopen-2016-015746
Additional Links:
http://bmjopen.bmj.com/content/7/8/e015746.info
Type:
Article
Language:
en
ISSN:
2044-6055
Appears in Collections:
Health

Full metadata record

DC FieldValue Language
dc.contributor.authorBature, Fideliaen
dc.contributor.authorGuinn, Barbara-Annen
dc.contributor.authorPang, Dongen
dc.contributor.authorPappas, Yannisen
dc.date.accessioned2017-09-21T12:58:33Z-
dc.date.available2017-09-21T12:58:33Z-
dc.date.issued2017-08-28-
dc.identifier.citationBature F, Guinn B, Pang D, Pappas Y (2017) 'Signs and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016', BMJ Open, 7 (8), pp.e015746.en
dc.identifier.issn2044-6055-
dc.identifier.doidx.doi.org/10.1136/bmjopen-2016-015746-
dc.identifier.urihttp://hdl.handle.net/10547/622211-
dc.description.abstractObjective Late diagnosis of Alzheimer’s disease (AD) may be due to diagnostic uncertainties. We aimed to determine the sequence and timing of the appearance of established early signs and symptoms in people who are subsequently diagnosed with AD. Methods We used systematic review methodology to investigate the existing literature. Articles were reviewed in May 2016, using the following databases: MEDLINE, PsycINFO, CINAHL, British Nursing Index, PubMed central and the Cochrane library, with no language restriction. Data from the included articles were extracted independently by two authors and quality assessment was undertaken with the quality assessment and diagnostic accuracy tool-2 (QUADAS tool-2 quality assessment tool). Results We found that depression and cognitive impairment were the first symptoms to appear in 98.5% and 99.1% of individuals in a study with late-onset AD (LOAD) and 9% and 80%, respectively, in early-onset AD (EOAD). Memory loss presented early and was experienced 12 years before the clinically defined AD dementia in the LOAD. However, the rapidly progressive late-onset AD presented predominantly with 35 non-established focal symptoms and signs including myoclonus (75%), disturbed gait (66%) and rigidity. These were misdiagnosed as symptoms of Creutzfeldt-Jacob disease (CJD) in all the cases. The participant with the lowest mini-mental state examination score of 25 remained stable for 2 years, which is consistent with the score of the healthy family members. Conclusions The findings of this review suggest that neurological and depressive behaviours are an early occurrence in EOAD with depressive and cognitive symptoms in the measure of semantic memory and conceptual formation in LOAD. Misdiagnosis of rapidly progressive AD as CJD and the familial memory score can be confounding factors while establishing a diagnosis. However, the study was limited by the fact that each one of the findings was based on a single study. * Alzheimer's disease (AD) * systematic scoping review * early signs and symptoms * mild cognitive impairment (MCI) * early stage of ADen
dc.language.isoenen
dc.publisherBritish Medical Journalen
dc.relation.urlhttp://bmjopen.bmj.com/content/7/8/e015746.infoen
dc.rightsGreen - can archive pre-print and post-print or publisher's version/PDF-
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAlzheimer's diseaseen
dc.titleSigns and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016en
dc.typeArticleen
dc.contributor.departmentUniversity of Bedfordshireen
dc.identifier.journalBMJ Openen
dc.date.updated2017-09-20T14:18:07Z-
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