年轻发病的阿尔茨海默病 (YOAD) 患者面临着长期的诊断延误。处方药的使用可以提供对早期体征和症状的深入了解，这可能有助于及时诊断。在一项基于登记的巢式病例对照研究中，我们检查了 2016 年至 2020 年在丹麦记忆诊所诊断为 YOAD 的每个人的药物使用情况，并与认知健康的控制。处方药的使用分为 13 个总体类别（消化道和代谢、血液和造血器官、心血管系统、皮肤科、泌尿生殖系统和性激素、全身激素制剂、全身用抗感染药、抗肿瘤和免疫调节剂、肌肉骨骼系统） 、神经系统、抗寄生虫产品、呼吸系统和感觉器官）。对研究人群中使用率至少为 5% 的预定子类别进行了进一步分层。条件逻辑回归产生优势比，考虑到使用发病率-密度匹配，该优势比可解释为发病率比（IRR）。在整个 10 年研究期间和三个时间间隔内检查了处方药使用与随后 YOAD 诊断之间的关联。该研究包括 1745 例 YOAD 病例和 5235 例对照。在主要分析中，几个总体类别显示在一个或多个时间间隔内与 YOAD 显着相关，即血液和造血器官和神经系统。与诊断前 10->5 年的对照相比，YOAD 病例中神经系统类别的处方药使用有所增加（IRR 1.17，95% CI 1.05-1.31），在 YOAD 病例中增加至 1.57（95% CI 1.39-1.78）。诊断前一年。这主要是由抗抑郁药和抗精神病药的使用推动的，对于首次使用者来说尤其突出。在这项研究中，多个类别的药物使用与 YOAD 相关。中年时出现需要治疗的精神症状，例如抑郁或精神病，可能是 YOAD 的潜在早期指标。© 2024。作者。

Patients with young onset Alzheimer's disease (YOAD) face long diagnostic delays. Prescription medication use may provide insights into early signs and symptoms, which may help facilitate timely diagnosis.In a register-based nested case-control study, we examined medication use for everyone diagnosed with YOAD in a Danish memory clinic during 2016-2020 compared to cognitively healthy controls. Prescription medication use were grouped into 13 overall categories (alimentary tract and metabolism, blood and blood forming organs, cardiovascular system, dermatologicals, genitourinary system and sex hormones, systemic hormonal preparations, antiinfectives for systemic use, antineoplastic and immunomodulating agents, musculo-skeletal system, nervous system, antiparasitic products, respiratory system, and sensory organs). Further stratifications were done for predetermined subcategories with a use-prevalence of at least 5% in the study population. Conditional logistic regression produced odds ratios, which given the use of incidence-density matching is interpretable as incidence rate ratios (IRRs). The association between prescription medication use and subsequent YOAD diagnosis was examined in the entire 10-year study period and in three time-intervals.The study included 1745 YOAD cases and 5235 controls. In the main analysis, several overall categories showed significant associations with YOAD in one or more time-intervals, namely blood and blood forming organs and nervous system. Prescription medication use in the nervous system category was increased for YOAD cases compared to controls already 10->5 years prior to diagnosis (IRR 1.17, 95% CI 1.05-1.31), increasing to 1.57 (95% CI 1.39-1.78) in the year preceding diagnosis. This was largely driven by antidepressant and antipsychotic use, and especially prominent for first-time users.In this study, medication use in several categories was associated with YOAD. Onset of treatment-requiring psychiatric symptoms such as depression or psychosis in mid-life may serve as potential early indicators of YOAD.© 2024. The Author(s).