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Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported
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1989
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AgingGeriatric MedicineEpidemiology Of AgingGeriatric NeurologyAlzheimer's DiseaseNeurologyAging-associated DiseasePublic HealthPopulationDefined Us CommunityCommunity PopulationPsychiatryGeriatricsVascular DementiaOlder PersonsRisk FactorsEpidemiologyProbable AlzheimerVascular Cognitive DisorderDementiaCommunity ResidentsMedicine
The study assessed Alzheimer’s disease prevalence in a U.S. community by conducting brief memory tests on 3,623 residents over 65, then performing neurological, neuropsychological, and laboratory examinations on a stratified sample of 467 participants to calculate community prevalence rates. Among community residents over 65, 10.3% were estimated to have probable Alzheimer’s disease, with prevalence rising sharply with age (3.0% in 65–74, 18.7% in 75–84, 47.2% over 85), other dementias were rare, and 84.1% of those with moderate or severe impairment had Alzheimer’s as the sole diagnosis, indicating a growing public health burden.
Clinically diagnosed Alzheimer's disease and other dementing illnesses were assessed in a geographically defined US community. Of 3623 persons (80.8% of all community residents over 65 years of age) who had brief memory testing in their homes, a stratified sample of 467 persons underwent neurological, neuropsychological, and laboratory examination. Prevalence rates of Alzheimer's disease were calculated for the community population from the sample undergoing clinical evaluation. Of those over the age of 65 years, an estimated 10.3% (95% confidence limits, 8.1% and 12.5%) had probable Alzheimer's disease. This prevalence rate was strongly associated with age. Of those 65 to 74 years old, 3.0% (95% confidence limits, 0.8 and 5.2) had probable Alzheimer's disease, compared with 18.7% (95% confidence limits, 13.2 and 24.2) of those 75 to 84 years old and 47.2% (95% confidence limits, 37.0 and 63.2) of those over 85 years. Other dementing conditions were uncommon. Of community residents with moderate or severe cognitive impairment, 84.1% had clinically diagnosed Alzheimer's disease as the only probable diagnosis. These data suggest that clinically diagnosed Alzheimer's disease is a common condition and that its public health impact will continue to increase with increasing longevity of the population. (<i>JAMA</i>. 1989;262:2551-2556)