Geriatric neurogenetics: oxymoron or reality?

Arch Neurol. 2008 Apr;65(4):537-9. doi: 10.1001/archneur.65.4.537.

Abstract

Background: Primary genetic diseases are generally associated with pediatric and young adult populations. Little information is available about the occurrence of single-gene mendelian diseases in elderly populations.

Objective: To describe the occurrence of single-gene neurogenetic disorders in a group of elderly patients.

Design: Retrospective review of neurogenetic cases in an academic medical center.

Setting: Academic university and Veterans Affairs medical centers.

Patients: Eight elderly patients with single-gene neurogenetic diseases were studied. These patients included an 87-year-old man and an 85-year-old man with Huntington disease, an 84-year-old woman with limb-girdle muscular dystrophy type 2A, a 78-year-old man with spinocerebellar ataxia type 14, an 86-year-old man with spinocerebellar ataxia type 5, an 85-year-old man with a presenilin 1 familial Alzheimer disease mutation, an 87-year-old man with autosomal dominant hereditary neuropathy, and a 78-year-old man with spinocerebellar ataxia type 6. Three patients had no family history of neurologic disease.

Main outcome measures: Medical histories, physical examination results, and genetic testing results.

Conclusions: Single-gene mendelian neurogenetic diseases can be found in the oldest old population (> 85 years). Such cases are currently underrecognized and will become more commonly observed in the future. This phenomenon is a result of (1) the aging of the general population, (2) better recognition of the highly variable ages at onset of genetic diseases, and (3) the availability of specific DNA-based genetic testing.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / genetics
  • Central Nervous System Diseases / diagnosis
  • Central Nervous System Diseases / genetics*
  • Charcot-Marie-Tooth Disease / diagnosis
  • Charcot-Marie-Tooth Disease / genetics
  • DNA Mutational Analysis
  • Diagnosis, Differential
  • Female
  • Genetic Diseases, Inborn / diagnosis
  • Genetic Diseases, Inborn / genetics*
  • Genetic Testing*
  • Humans
  • Huntington Disease / diagnosis
  • Huntington Disease / genetics
  • Male
  • Muscular Dystrophies, Limb-Girdle / diagnosis
  • Muscular Dystrophies, Limb-Girdle / genetics
  • Neurodegenerative Diseases / diagnosis
  • Neurodegenerative Diseases / genetics*
  • Neurologic Examination
  • Spinocerebellar Ataxias / diagnosis
  • Spinocerebellar Ataxias / genetics