Survival in Alzheimer disease: a multiethnic, population-based study of incident cases.
OBJECTIVE
To describe factors associated with survival in Alzheimer disease (AD) in a multiethnic, population-based longitudinal study.


METHODS
AD cases were identified in the Washington Heights Inwood Columbia Aging Project, a longitudinal, community-based study of cognitive aging in Northern Manhattan. The sample comprised 323 participants who were initially dementia-free but developed AD during study follow-up (incident cases). Participants were followed for an average of 4.1 (up to 12.6) years. Possible factors associated with shorter lifespan were assessed using Cox proportional hazards models with attained age as the time to event (time from birth to death or last follow-up). In subanalyses, median postdiagnosis survival durations were estimated using postdiagnosis study follow-up as the timescale.


RESULTS
The mortality rate was 10.7 per 100 person-years. Mortality rates were highest [corrected] among those diagnosed at older ages, and among non-Hispanic whites compared to [corrected] Hispanic [corrected] The median lifespan of the entire sample was 92.2 years (95% CI: 90.3, 94.1). In a multivariable-adjusted Cox model, history of diabetes and history of hypertension were independently associated with a shorter lifespan. No differences in lifespan were seen by race/ethnicity after multivariable adjustment. The median postdiagnosis survival duration was 3.7 years among non-Hispanic whites, 4.8 years among African Americans, and 7.6 years among Hispanics.


CONCLUSIONS
Factors influencing survival in Alzheimer disease include race/ethnicity and comorbid diabetes and hypertension.
Helzner
E P
EP
Gertrude H Sergievsky Center, Columbia University Medical Center, New York, NY 10032, USA.
Scarmeas
N
N
Cosentino
S
S
Tang
M X
MX
Schupf
N
N
Stern
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality*; D005006:Ethnicity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate