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Response from authors

  • Bryan D. James, Assistant professor, Rush Alzheimer's Disease Centerbryan_james@rush.edu
  • Bryan James, Sue Leurgans, David Bennett; Chicago, IL
Submitted March 24, 2014

We appreciate Dr. Campbell-Taylor???s feedback and regret any confusion. We appreciate the distinction between "immediate" and "underlying" causes of death, and it is up to the CDC to decide how US death certificates are to be completed. Our goal was to estimate excess deaths due to Alzheimer's disease (AD) regardless of the immediate or secondary causes of death. Therefore, we prospectively followed older persons without dementia, accurately counted who developed AD, and the excess deaths associated with having AD. This approach is agnostic to the exact series of events that lead to death. It strongly implicates AD as an underlying cause in many more deaths than reported. Our crude estimate of 500,000+ excess deaths in the US is likely valid, although it will be important to see results from other cohort studies. We introduced the concept of "mixed mortality" to reflect how many chronic conditions contribute to death in old age. Trying to identify a single cause of death may not accurately reflect the process of dying for most older persons. Overall, our study suggests that developing AD markedly increases one's risk of death and contributes to more than half a million deaths in the US each year.

For disclosures, please contact the editorial office at journal@neurology.org.

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Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

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