Estimation of lifetime risks of Alzheimer's disease dementia using biomarkers for preclinical disease

Alzheimers Dement. 2018 Aug;14(8):981-988. doi: 10.1016/j.jalz.2018.03.005. Epub 2018 May 22.


Introduction: Lifetime risks are the probabilities of progressing to Alzheimer's disease (AD) dementia during one's lifespan. Here, we report the first estimates of the lifetime and ten-year risks of AD dementia based on age, gender, and biomarker tests for preclinical disease.

Methods: We used a multistate model for the disease process together with US death rates.

Results: Lifetime risks of AD dementia vary considerably by age, gender, and the preclinical or clinical disease state of the individual. For example, the lifetime risks for a female with only amyloidosis are 8.4% for a 90-year old and 29.3% for a 65-year old. Persons younger than 85 years with mild cognitive impairment, amyloidosis, and neurodegeneration have lifetime risks of AD dementia greater than 50%.

Discussion: Most persons with preclinical AD will not develop AD dementia during their lifetimes. Lifetime risks help interpret the clinical significance of biomarker screening tests for AD.

Keywords: Alzheimer's disease; Lifetime risks; Preclinical; Prediction.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / etiology
  • Alzheimer Disease / mortality
  • Biomarkers*
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / mortality
  • Dementia* / etiology
  • Dementia* / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Risk


  • Biomarkers