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NEUROLOGY 1993;43:515
© 1993 American Academy of Neurology

Incidence of dementia and probable Alzheimer's disease in a general population

The Framingham Study

D. L. Bachman, MD, P. A. Wolf, MD, R. T. Linn, PhD, J. E. Knoefel, MD, J. L. Cobb, MPH, A. J. Belanger, MS, L. R. White, MD and R. B. D'Agostino, PhD

Department of Neurology (Dr. Bachman), Medical University of South Carolina, Charleston, SC; the Department of Neurology (Drs. Wolf, Linn, and Knoefel), Boston University School of Medicine, and the Department of Mathematics (J.L. Cobb, A.J. Belanger, and Dr. D'Agostino), Boston University, Boston, MA; and the Epidemiology, Demography, and Biometry Program (Dr. White), the National Institute on Aging, Bethesda, MD.

objective: To determine the incidence of dementia and Alzheimer's disease (AD) in a general population sample.

Background: Utilizing subjects in the Framingham Study cohort determined to be free of dementia in 1976 to 1978, or on biennial examination 17 in 1982, all new cases of dementia arising in this cohort over a maximum of 10 years of follow-up were ascertained.

Methods: On biennial examination 14/15, a screening neuropsychologic examination was administered to 2,117 subjects, and cases of probable prevalent dementia were identified. Beginning on examination 17 and on all successive biennial examinations, a Mini-Mental State Examination was administered. Subjects previously free of dementia and falling below age-education levels were evaluated by a neurologist and neuropsychologist to determine if dementia was present and to ascertain the dementia type using standard criteria.

Results: Five-year incidence of dementia increased with age, doubling in successive 5-year age groups. Dementia incidence rose from 7.0 per 1,000 at ages 65 to 69 to 118.0 per 1,000 at ages 85 to 89 for men and women combined. Incidence of probable AD also doubled with successive quinquennia from 3.5 at ages 65 to 69 to 72.8 per 1,000 at ages 85 to 89 years. Incidence of dementia and of probable AD did not level off with age and was not different in men and women.

Conclusions: In a general population sample, we determined incidence of dementia and of probable AD and will use these incident cases for study of precursors and natural history in this elderly cohort, which has been under close surveillance for over 40 years.

Address correspondence and reprint requests to Dr. Philip A. Wolf, Department of Neurology, Boston University School of Medicine, 80 East Concord Street, B608, Boston, MA 02118.

Supported by the National Institute on Aging grant 5-R01-AG08122-05 and NHLBI contract N01-HC-38038.

Received May 22, 1992. Accepted for publication in final form July 29, 1992.




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