Study identifies predictors of Alzheimer's disease longevity

ited from a database of 23,000 people listed in an Alzheimer's Disease Patient Registry in the Seattle area. The average follow-up period was about 5 years, with an approximate range from 2 1/2 months to 14 years.

As they entered the study, each person was evaluated for cognitive and memory problems and examined for other conditions including heart disease, heart failure, diabetes, stroke, depression, and urinary incontinence. They were also assessed for a history of agitation, wandering, paranoia, falls and walking difficulties. Survival was measured from the time of initial diagnosis until death or when the study ended in 2001.

When compared to the life expectancy of the general U.S. population, overall survival was lower for people with AD in all age groups. For instance, median* survival was 8 years for women aged 70 diagnosed with AD, which is about half the life expectancy of similarly aged American women who do not have the disease. Similar trends were found among 70-year old men with AD who had a median survival time of 4.4 years compared with 9.3 years for the U.S. population.

Survival was poorest among those aged 85 and older who wandered, had walking problems and had histories of diabetes and congestive heart failure. However, the difference in the life expectancy between those who were diagnosed with AD and the general population progressively diminished with age. At 85, for example, median life expectancy for women with AD was 3.9 years after diagnosis compared to about 6 years for women who didn't have the disease. Similarly, 85-year-old men with newly diagnosed AD had a median life expectancy of 3.3 years compared to 4.7 for men of the same age who didn't have AD.

Poor scores on the initial tests of memory and cognitive performance predicted shorter survival time after diagnosis. In fact, a five-point drop in one key test, the Mini-Mental State Exam, during the first year following diagnosis predicted up to a 66 percent increa

Contact: Doug Dollemore
NIH/National Institute on Aging

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