Age-specific incidence of Alzheimer's disease in a community population

Objective. - To determine age-specific incidence rates of clinically diagnosed Alzheimer's disease. Design. - Cohort, followed a mean of 4.3 years. Setting. - East Boston, Mass. Participants. - Of 2313 persons aged 65 years and older who were initially free of Alzheimer's disease, 1601 participated in the ascertainment of incident disease (80% of survivors), 409 declined participation, and 303 died before the end of the follow-up period. A stratified sample of 642 persons received detailed clinical evaluation. Outcome Measure. - Diagnosis of new probable Alzheimer's disease through structured clinical evaluation including neurologic, neuropsychological, and psychiatric examination. Community incidence rates were computed by 5-year age groups, adjusted for gender, single year of age, length of follow-up interval, and sampling design. Results. - The estimated annual incidence of Alzheimer's disease in the population was 0.6% (95% confidence interval [CI], 0.3% to 0.9%) for persons aged 65 to 69 years, 1.0% (95% CI, 0.6% to 1.4%) for persons aged 70 to 74 years, 2.0% (95% CI, 1.3% to 2.7%) for persons aged 75 to 79 years, 3.3% (95% CI, 2.2% to 4.4%) for persons aged 80 to 84 years, and 8.4% (95% CI, 3.7% to 13.1%) for persons aged 85 years and older. Conclusions. - The incidence of Alzheimer's disease is substantial and is approximately 14 times higher among persons older than 85 years compared with those between 65 and 69 years of age.