Predicting age at Alzheimer's dementia onset with the cognitive clock

Alzheimers Dement. 2023 Aug;19(8):3555-3562. doi: 10.1002/alz.13004. Epub 2023 Feb 24.


Introduction: Intervention of Alzheimer's dementia hinges on early diagnosis and advanced planning. This work utilizes the cognitive clock, a novel indicator of brain health, to develop a dementia prediction model that can be easily applied in broad settings.

Methods: Data came from over 3000 community-dwelling older adults. Cognitive age was estimated by aligning Mini-Mental State Examination (MMSE) scores to a clock that represents the typical cognitive aging profile. We identified a mean cognitive age at Alzheimer's dementia onset and predicted the corresponding chronological age at person-specific level.

Results: The mean chronological age at baseline was 78 years. A total of 881 (28%) participants developed Alzheimer's dementia. The mean cognitive age at onset was 91 years. The predicted chronological age at onset had a mean (standard deviation) of 87.6 (6.7) years. The model's prediction accuracy was supported by multiple testing statistics.

Discussion: Our model offers an easy-to-use tool for predicting person-specific age at Alzheimer's dementia onset.

Keywords: Alzheimer's dementia; age at onset; cognitive aging; cognitive clock; dynamic prediction.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / diagnosis
  • Brain
  • Cognition
  • Cognitive Dysfunction*
  • Humans
  • Independent Living