Eric B. Larson, MD, MPH; Marie-Florence Shadlen, MD; Li Wang, MS; Wayne C. McCormick, MD, MPH; James D. Bowen, MD; Linda Teri, PhD; Walter A. Kukull, PhD
Grant Support: By National Institute on Aging grant AG 06781 and by a Minority Supplement to National Institute of Aging grant AG 06781-13S1 to the University of Washington Alzheimer's Disease Patient Registry.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Eric B. Larson, MD, MPH, Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448; e-mail, email@example.com.
Current Author Addresses: Dr. Larson: Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448.
Drs. Shadlen and McCormick: Division of Gerontology and Geriatric Medicine, University of Washington School of Medicine, Harborview Medical Center, 325 9th Avenue, Box 359755, Seattle, WA 98104-2499.
Ms. Wang: Division of General Internal Medicine, University of Washington Medical Center, 4225 Roosevelt Way NE, Suite 301, Box 354691, Seattle, WA 98105.
Dr. Bowen: Department of Neurology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356465, Seattle, WA 98195.
Dr. Teri: Department of Psychosocial and Community Health, University of Washington School of Nursing, 9709 3rd Avenue NE, Suite 507, Seattle, WA 98115-2053.
Dr. Kukull: Department of Epidemiology, University of Washington School of Public Health, 4311 11th Avenue NE, Suite 300, Seattle, WA 98105.
Author Contributions: Conception and design: E.B. Larson, M.-F. Shadlen, L. Wang, J.D. Bowen, L. Teri, W.A. Kukull.
Analysis and interpretation of the data: E.B. Larson, M.-F. Shadlen, L. Wang, W.C. McCormick, L. Teri, W.A. Kukull.
Drafting of the article: E.B. Larson, M.-F. Shadlen, L. Wang, W.C. McCormick.
Critical revision of the article for important intellectual content: E.B. Larson, M.-F. Shadlen, L. Wang, W.C. McCormick, J.D. Bowen, L. Teri, W.A. Kukull.
Final approval of the article: E.B. Larson, M.-F. Shadlen, L. Wang, W.C. McCormick, J.D. Bowen, L. Teri, W.A. Kukull.
Provision of study materials or patients: E.B. Larson, W.C. McCormick, J.D. Bowen, L. Teri, W.A. Kukull.
Statistical expertise: L. Wang.
Obtaining of funding: E.B. Larson, L. Teri, W.A. Kukull.
Administrative, technical, or logistic support: E.B. Larson, W.C. McCormick, L. Teri.
Collection and assembly of data: E.B. Larson, L. Wang, L. Teri, W.A. Kukull.
Larson E., Shadlen M., Wang L., McCormick W., Bowen J., Teri L., Kukull W.; Survival after Initial Diagnosis of Alzheimer Disease. Ann Intern Med. 2004;140:501-509. doi: 10.7326/0003-4819-140-7-200404060-00008
Download citation file:
Published: Ann Intern Med. 2004;140(7):501-509.
The prognosis in patients with Alzheimer disease may be associated with specific patient characteristics observed shortly after diagnosis.
Severity of initial cognitive impairment and deterioration in the Mini-Mental State Examination score during the first year after diagnosis were strongly associated with decreased survival. Men had shorter survival than women across all age groups. Frontal lobe release signs, gait disturbances, falling, congestive heart failure, and diabetes were all associated with decreased survival.
Early appraisal of patients with Alzheimer disease may help set expectations and priorities for planning patient care.
Alzheimer disease is one of the leading causes of death in older people (1). One recent study suggests that 7.1% of all deaths in 1995 were attributable to Alzheimer disease, placing it on a par with cerebrovascular disease as the third leading cause of death (2). Estimates of predicted survival of persons who have received a diagnosis of Alzheimer disease should be useful for patients, caregivers, clinicians, and policy planners. Previous studies that relied on epidemiologic surveys had little opportunity to analyze clinical factors and also may not be generalizable to everyday clinical settings. Results from other studies that were based on convenience samples of persons from specialized Alzheimer disease centers are probably subject to referral bias. Our study design allowed us to estimate the magnitude of the reduction in age-adjusted life expectancy attributable to Alzheimer disease in a cohort of patients similar to those encountered in the clinical setting where Alzheimer disease is initially recognized.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only