Survival in AD in a study of incident cases also found no differences in mortality by race or ethnicity Bicalutamide buy but did report that a history of diabetes or hypertension was associated with a shorter life span [23], whereas our study did not confirm the risk of death due to these comorbidities (as discussed below). Our results were in agreement with those of another study [24] that evaluated cognitive decline and survival in patients with AD and found no relationship between survival and educational attainment. Our results confirm previous findings that some of the factors that predict survival in the general population are also relevant to AD; specifically, several of the main predictors for survival in AD are age [8] and sex [1,4,25,26] along with an impairment or decline in functional abilities [27,28].

Every 1-point increase on the PSMS, which measures the ability to perform basic activities of daily living and is scored on a scale of 0 to 30 points, was associated with an increased risk of death of 10% per year. Like the investigators in a large population study that was performed in the UK and that used multivariable adjustment [29], we found that disease severity is not associated with survival. Neither disease severity at baseline nor time-dependent changes in the MMSE score influenced survival. However, the PPR indicates the rate at which a patient declines following the onset of symptoms, presumably an intrinsic disease progression rate, and was significantly associated with increased risk of death.

We previously reported that patients who are slow progressors have significantly reduced mortality compared with fast progressors (hazard ratio = 0.62, 95% CI = 0.43 to 0.91, P = 0.024), but the mortality between intermediate and fast progressors did not reach significance in that study (hazard ratio = 0.81, 95% CI = 0.59 to 1.15, P = 0.24) [27]. The present study suggests that the survival advantage associated with the PPR is on a continuum and not limited to those with slowest disease progression. It is often presumed that medical comorbidities should also influence survival with AD. Diabetes, hypertension, hyperlipidemia, coronary disease, and cerebrovascular disease at baseline did not influence survival in this cohort. This result was similar to that of another study [28] and could be a consequence of length bias or the fact that patients with severe medical comorbidity may never seek treatment for dementia.

The study which Entinostat did find that these comorbidites reduced survival [25] did not examine the other covariates used in our analysis. Although studies suggest that atypical antipsychotic drugs increase risk of death download the handbook in older patients with dementia [7] and the use of traditional or typical agents is associated with even greater risk of death [5,6], we could not replicate these findings in our outpatient-based sample.