Alzheimer's Disease: Predicting Survival
New Answers to Biggest Question: How Long?
April 5, 2004 -- When the doctor says "Alzheimer's
disease," it's usually the first question patients and family members ask:
"How long have we got?"
There's still no way to give a precise answer. But new data
paint a much sharper picture of how long a person with Alzheimer's disease will
survive -- and how fast the disease will progress.
Take the Alzheimer's Quiz.
The information comes from a study of 521 Seattle residents
aged 60 and older recently diagnosed with Alzheimer's disease. Eric B. Larson,
MD, MPH, director of the Center for Health Studies at the Group Health
Cooperative, an HMO based in Washington state, led the study.
"Now you can give patients an idea of just how long, on
average, they are going to live," Larson tells WebMD. "And you can
distinguish those with a worse prognosis from those with a better one."
Earlier studies tended to look at hospitalized patients, who
are much farther along in the course of their disease. Larson's team found
patients nearly as soon as they received their Alzheimer's disease diagnosis.
That makes the findings much more relevant to real life, says Neil Buckholtz,
PhD, chief of the National Institute on Aging's dementia branch.
"This study supports what we have been saying for a long
time. Alzheimer's survival is highly variable: five to 20 years," Buckholtz
tells WebMD. "President Reagan, for example, has survived for quite some
time. It is quite variable for individuals."
The findings appear in the April 6 issue of Annals of
Planning for the Alzheimer's Future
For Larson, the many issues surrounding the care of a person
with Alzheimer's disease are personal as well as professional.
"When I started to see my father declining, it took a long
time for my family to get comfortable with that," he says. "The nice
thing with this study is that everyone in it was within a year of diagnosis.
This was like the real world. Now the family can say, 'This is what is ahead.
Let's face it like anything else in life.'"
People with Alzheimer's disease, Larson found, have about half
the life expectancy of a same-age person without Alzheimer's. Even so, many
people with the disease have lots of life ahead of them.
"A fairly large number of people with Alzheimer's disease
are going to live a long time," Larson says. "For example, one in four
women diagnosed with Alzheimer's disease will live for 10 more years. That is a
lot of years of care to plan for."
The Long and Short of Alzheimer's Survival
Larson's team found that several factors predict
- Women with Alzheimer's disease live longer than men with Alzheimer's
- Unsteadiness in walking predicts shorter survival.
- Wandering behavior predicts shorter survival.
- Involuntary loss of urine predicts shorter survival.
- A poor score on tests of mental status predicts shorter survival.
- A rapid mental decline in the first year after diagnosis predicts shorter
- Pre-existing heart disease or diabetes predicts shorter survival.