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Neurology 2002;58:907-911
© 2002 American Academy of Neurology

Increased familial risk of the psychotic phenotype of Alzheimer disease

R. A. Sweet, MD, V. L. Nimgaonkar, MD PhD, B. Devlin, PhD, O. L. Lopez, MD and S. T. DeKosky, MD

From the Division of Geriatrics and Neuropsychiatry (Drs. Sweet and DeKosky), Department of Psychiatry (Drs. Nimgaonkar and Devlin), Department of Neurology (Drs. Lopez and DeKosky), School of Medicine, and the Department of Human Genetics (Drs. Nimgaonkar and Devlin), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.

Address correspondence and reprint requests to Dr. Robert A. Sweet, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213; e-mail: SweetRA{at}MSX.UPMC.EDU

Background: Psychotic symptoms in patients with AD (AD with psychosis [AD+P]) define a phenotype characterized by more rapid cognitive and functional decline and a liability to aggressive behaviors. Objective: To determine if AD+P aggregates within families.

Methods: Case-control study of AD+P frequency in 461 siblings of 371 probands diagnosed with AD. All siblings were ascertained as part of a genetic investigation and also were diagnosed with AD. Statistical analysis used Generalized Estimating Equations to adjust for clustering within families.

Results: AD+P in probands was associated with a significantly increased risk for AD+P in family members (OR, 2.41; 95% CI 1.46–4.0; p = 0.0006). The correlation among siblings for AD+P status was modest: 0.16.

Conclusion: AD+P demonstrates familial aggregation. Further studies are required to investigate a possible genetic basis of AD+P.




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