NEUROLOGICAL AND PSYCHIATRIC PREDICTORS OF MORTALITY IN PATIENTS WITHALZHEIMER-DISEASE IN CALIFORNIA

Objective: To determine whether neurological and psychiatric symptoms predict survival time among patients with Alzheimer disease (AD) after adjusting for the influence of sociodemographic variables, health con ditions, and dementia severity separately for men and women. Design: T he sample consisted of 936 men and women diagnosed as having probable or possible AD at 1 of 7 Alzheimer's Disease Diagnostic and Treatment Centers throughout California from 1986 through 1990. Data on dementia severity, comorbid conditions, and demographic characteristics were c ollected at the time of AD diagnosis. Data on vital status and dates o f death were obtained by linking the patient file Co several administr ative databases maintained by the California State and federal governm ents. The mean length of follow-up was 31 months. Data were analyzed w ith Kaplan-Meier survival curves and Cox proportional hazards models. Results: Men had shorter survival times than did women (log-rank test, 30.93, P<.001). Among men, but not women, survival times were negativ ely associated with selected neurological and psychiatric symptoms. Am ong women, but not men, a history of cardiovascular conditions was ass ociated with poorer survival. Conclusions: Patterns of survival and pr edictors of survival time among patients with AD differ by sex. Future studies of survival and progression of AD need to examine men and wom en separately.