The proposed study will identify elderly individuals with recent onset of cognitive dysfunction and correspond individuals with no dysfunction living in a geographically defined, urban community, East Boston, Massachussets. These individuals will undergo detailed evaluations to identify incident cases of Alzheimer's disease as well as, persons of the same age and gender who are unaffected. The proposed study will efficiently take advantage of two already-funded population efforts in the community: An initial total community census and comprehensive survey of the population 65 years of age and older conducted in 1982, and a follow-up of the over 3,700 members of this cohort of elderly individuals being conducted in 1985. The role of several possible etiologic factors in the incident occurrence of Alzheimer's disease will be investigated. Exposures possibly related to Alzheimer's disease which were measured at the 1982 population survey of those 65 years of age and older offer a noteworthy advantage over the usual case-control data in investigating the possible relation of these risk factors to Alzheimer's disease. In addition, blood samples will be obtained from both case and control individuals for storage under carefully controlled conditions, permitting the investigation of future etiologic hypotheses without repeating the entire study. Those individuals having Alzheimer's disease of recent onset will be followed for three years. The endpoints of greatest interest will be change in cognitive function, hospitalization, institutionalization, and mortality. Mortality and hospitalization will be determined by continual surveillance of the entire community; change in cognitive function will measured at yearly reexaminations. The study will also provide descriptive data including estimates of incidence for Alzheimer's disease for a defined community population.
