Duration of preclinical, prodromal, and dementia stages of Alzheimer's disease in relation to age, sex, and APOE genotype

Research output: Contribution to journalArticle


Introduction: We estimated the age-specific duration of the preclinical, prodromal, and dementia stages of Alzheimer's disease (AD) and the influence of sex, setting, apolipoprotein E (APOE) genotype, and cerebrospinal fluid tau on disease duration. Methods: We performed multistate modeling in a combined sample of 6 cohorts (n = 3268) with death as the end stage and estimated the preclinical, prodromal, and dementia stage duration. Results: The overall AD duration varied between 24 years (age 60) and 15 years (age 80). For individuals presenting with preclinical AD, age 70, the estimated preclinical AD duration was 10 years, prodromal AD 4 years, and dementia 6 years. Male sex, clinical setting, APOE ε4 allele carriership, and abnormal cerebrospinal fluid tau were associated with a shorter duration, and these effects depended on disease stage. Discussion: Estimates of AD disease duration become more accurate if age, sex, setting, APOE, and cerebrospinal fluid tau are taken into account. This will be relevant for clinical practice and trial design. © 2019 the Alzheimer's Association


  • Alzheimer's Disease Neuroimaging Initiative
  • AIBL Research Group
  • Lisa Vermunt
  • Åsa Wallin
  • Pieter-Jelle Visser
External organisations
  • Vrije Universiteit Amsterdam
  • Maastricht University
  • VU University Medical Center
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Neurology


  • Alzheimer's disease, APOE, Clinical setting, Dementia, Disease duration, Multistate model, Preclinical, Prodromal, Progression
Original languageEnglish
JournalAlzheimer's and Dementia
Publication statusE-pub ahead of print - 2019 Jun 1
Publication categoryResearch

Bibliographic note

Export Date: 18 June 2019