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Volume 344:1111-1116 April 12, 2001 Number 15 Next

	Full Text PDF Editorial by Kawas, C. H. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Dementia shortens life expectancy; estimates of median survival after the onset of dementia have ranged from 5 to 9.3 years. Previous studies of people with existing dementia, however, may have underestimated the deleterious effects of dementia on survival by failing to consider persons with rapidly progressive illness who died before they could be included in a study (referred to as length bias).

Methods We used data from the Canadian Study of Health and Aging to estimate survival from the onset of symptoms of dementia; the estimate was adjusted for length bias. A random sample of 10,263 subjects 65 years old or older from throughout Canada was screened for cognitive impairment. For those with dementia, we ascertained the date of onset and conducted follow-up for five years.

Results We analyzed data on 821 subjects, of whom 396 had probable Alzheimer's disease, 252 had possible Alzheimer's disease, and 173 had vascular dementia. For the group as a whole, the unadjusted median survival was 6.6 years (95 percent confidence interval, 6.2 to 7.1). After adjustment for length bias, the estimated median survival was 3.3 years (95 percent confidence interval, 2.7 to 4.0). The median survival was 3.1 years for subjects with probable Alzheimer's disease, 3.5 years for subjects with possible Alzheimer's disease, and 3.3 years for subjects with vascular dementia.

Conclusions Median survival after the onset of dementia is much shorter than has previously been estimated.

Source Information

From the Department of Epidemiology and Biostatistics and the Division of Geriatric Medicine (C.W.) and the Department of Mathematics and Statistics (D.B.W., C.E.M.), McGill University, Montreal; the Department of Mathematics and Statistics, York University, Toronto (M.A.); the Department of Community and Family Medicine, Duke University, Durham, N.C. (T.Ø.); the Division of Geriatric Medicine, Dalhousie University, Halifax, N.S., Canada (K.R.); and the Department of Medicine, University of Calgary, Alta., Canada (D.B.H.).

Address reprint requests to Dr. Christina Wolfson at the Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Côte Ste. Catherine Road, Montreal, QC H3T 1E2, Canada, or at tinaw{at}epid.jgh.mcgill.ca.

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