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Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States.

Publication ,  Journal Article
Wilson, RS; Weir, DR; Leurgans, SE; Evans, DA; Hebert, LE; Langa, KM; Plassman, BL; Small, BJ; Bennett, DA
Published in: Alzheimers Dement
January 2011

BACKGROUND: The prevalence of Alzheimer's disease (AD) in the United States was estimated at 2.3 million in 2002 by the Aging, Demographics, and Memory Study (ADAMS), which is almost 50% less than the estimate of 4.5 million in 2000 derived from the Chicago Health and Aging Project. METHODS: We considered how differences in diagnostic criteria may have contributed to these differences in AD prevalence. RESULTS: We identified several important differences in diagnostic criteria that may have contributed to the differing estimates of AD prevalence. Two factors were especially noteworthy. First, the Diagnostic and Statistical Manual of Mental Disorders III-R and IV criteria of functional limitation documented by an informant used in ADAMS effectively concentrated the diagnosis of dementia toward a relatively higher level of cognitive impairment. ADAMS separately identified a category of cognitive impairment not dementia and within that group there were a substantial number of cases with "prodromal" AD (a maximum of 1.95 million with upweighting). Second, a substantial proportion of dementia in ADAMS was attributed to either vascular disease (representing a maximum of 0.59 million with upweighting) or undetermined etiology (a maximum of 0.34 million), whereas most dementia, including mixed dementia, was attributed to AD in the Chicago Health and Aging Project. CONCLUSION: The diagnosis of AD in population studies is a complex process. When a diagnosis of AD excludes persons meeting criteria for vascular dementia, when not all persons with dementia are assigned an etiology, and when a diagnosis of dementia requires an informant report of functional limitations, the prevalence is substantially lower and the diagnosed cases most likely have a relatively higher level of impairment.

Duke Scholars

Published In

Alzheimers Dement

DOI

EISSN

1552-5279

Publication Date

January 2011

Volume

7

Issue

1

Start / End Page

74 / 79

Location

United States

Related Subject Headings

  • United States
  • Prevalence
  • Male
  • Incidence
  • Humans
  • Geriatrics
  • Female
  • Diagnosis, Differential
  • Dementia
  • Comorbidity
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wilson, R. S., Weir, D. R., Leurgans, S. E., Evans, D. A., Hebert, L. E., Langa, K. M., … Bennett, D. A. (2011). Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States. Alzheimers Dement, 7(1), 74–79. https://doi.org/10.1016/j.jalz.2010.11.006
Wilson, Robert S., David R. Weir, Sue E. Leurgans, Denis A. Evans, Liesi E. Hebert, Kenneth M. Langa, Brenda L. Plassman, Brent J. Small, and David A. Bennett. “Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States.Alzheimers Dement 7, no. 1 (January 2011): 74–79. https://doi.org/10.1016/j.jalz.2010.11.006.
Wilson RS, Weir DR, Leurgans SE, Evans DA, Hebert LE, Langa KM, et al. Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States. Alzheimers Dement. 2011 Jan;7(1):74–9.
Wilson, Robert S., et al. “Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States.Alzheimers Dement, vol. 7, no. 1, Jan. 2011, pp. 74–79. Pubmed, doi:10.1016/j.jalz.2010.11.006.
Wilson RS, Weir DR, Leurgans SE, Evans DA, Hebert LE, Langa KM, Plassman BL, Small BJ, Bennett DA. Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States. Alzheimers Dement. 2011 Jan;7(1):74–79.
Journal cover image

Published In

Alzheimers Dement

DOI

EISSN

1552-5279

Publication Date

January 2011

Volume

7

Issue

1

Start / End Page

74 / 79

Location

United States

Related Subject Headings

  • United States
  • Prevalence
  • Male
  • Incidence
  • Humans
  • Geriatrics
  • Female
  • Diagnosis, Differential
  • Dementia
  • Comorbidity