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Catherine M. Roe, PhD; Chengjie Xiong, PhD; Elizabeth Grant, PhD; J. Phillip Miller, BA; John C. Morris, MD

Arch Neurol. 2008;65(1):108-111.

Objectives  To examine whether reported age at onset of dementia symptoms among participants with Alzheimer disease (AD) is later for those with fewer years of education and, if so, to see if education is attributed to delayed detection of symptoms.

Design  Case series.

Setting  National Alzheimer's Coordinating Center Minimum Data Set (N = 21 880 participants) and Washington University Alzheimer's Disease Research Center (N = 1449 participants).

Results  Reported age at onset of dementia symptoms is slightly younger in participants with more education. Participants with fewer years of education show greater clinical severity of Alzheimer disease at first assessment.

Conclusion  Symptoms of Alzheimer disease are recognized later among those with less education.

Author Affiliations: Division of Biostatistics (Drs Roe, Xiong, and Grant and Mr Miller), Alzheimer's Disease Research Center (Drs Roe, Xiong, Grant, and Morris and Mr Miller), and Departments of Neurology, Pathology and Immunology, and Physical Therapy (Dr Morris), Washington University School of Medicine, St Louis, Missouri. Dr Roe is now in the Department of Neurology at the Alzheimer's Disease Research Center, Washington University School of Medicine.

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