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Joseph M. and Kathleen P. Bryan Alzheimer's Disease Research Center, the Division of Neurology, Department of Medicine (Drs. Heyman and Hurwitz, Ms. Haynes, Ms. Gwyther, and Ms. Utley), and the Division of Biometry, Department of Community and Family Medicine (Dr. Wilkinson and Mr. Helms), Duke University Medical Center, Durham, NC.
Follow-up observations were made of 92 white patients with early-onset Alzheimer's disease to determine the demographic, clinical, and neuropsychological factors predictive of institutionalization or death. The cumulative mortality rate 5 years after entry into the study was 23.9%, compared with an expected rate of 9.5%. The 5-year cumulative rate of admission to nursing homes was 62.8%. The language ability of the patients on entry to the study, their scores on a brief screening test of cognitive function, and their overall ratings of clinical dementia were found to be predictors of subsequent institutional care and death. The age of the patients had a significant modifying effect on these predictive factors, resulting in a greater risk of institutionalization and death in younger patients with severe cognitive impairment as compared with older individuals with the same degree of dysfunction.
Address correspondence and reprint requests to Dr. Heyman, Box 3203, Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, NC 27710.
Supported in part by Research Career Award # 5K6-NS-16677 and by grant ElP50-AGO-5128 from the National Institutes of Health and by grant RR-30 from the General Clinical Research Centers Program, Division of Research Resources, National Institutes of Health.
Received July 10, 1986. Accepted for publication in final form September 19, 1986.
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