Cumulative Risks of Developing Extrapyramidal Signs, Psychosis, or Myoclonus in the Course of Alzheimer's Disease

doi:10.1001/archneur.1991.00530230049020

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Vol. 48 No. 11, November 1991

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Cumulative Risks of Developing Extrapyramidal Signs, Psychosis, or Myoclonus in the Course of Alzheimer's Disease

Jenn-Yeu Chen, PhD; Yaakov Stern, PhD; Mary Sano, PhD; Richard Mayeux, MD

Arch Neurol. 1991;48(11):1141-1143.

Abstract

• Cumulative risks of developing extrapyramidal signs,psychosis, and myoclonus in the course of Alzheimer's disease(AD) were estimated in 72 patients with probable AD by the Kaplan-Meiersurvival method. The cumulative risk functions were found toincrease at different rates for different signs as AD progressed.Comparisons of the cumulative risk functions revealed that inthe early stages of AD, extrapyramidal signs and psychosis weremore likely to develop than myoclonus. As AD progressed, therisk of developing myoclonus became as great as that of developingthe other two signs. This study suggests that extrapyramidalsigns, psychosis, and myoclonus represent developmental featuresthat mark the progression of AD, rather than indicators of diseasesubtypes. The estimated cumulative risk functions set a reasonableexpectation for the timing and likelihood of the emergence ofthe clinical signs. This, in turn, might aid in disease prognosisbecause the biological bases of these signs have been establishedand they have been shown to be predictive of other markers ofdisease course.

Author Affiliations

From the Departments of Neurology (Drs Chen, Stern, Sano, and Mayeux) and Psychiatry (Drs Stern and Mayeux), Columbia University, College of Physicians and Surgeons, Memory Disorders Clinic, New York State Psychiatric Institute and Alzheimer's Disease Research Center, New York, NY.

Footnotes

Accepted for publication May 29, 1991.

Reprint requests to the Neurological Institute, 710 W 168thSt, New York, NY 10032 (Dr Stern).

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