In Reply

Abstract

Drs. Boersma and Eefsting are correct in stating that clinical diagnosis was made at an undefined moment during the course of the disease in our study of 100 autopsy-confirmed Alzheimer's disease patients.1 The insidious onset of this disease is but one reason for the observed differences in the time from symptom onset to clinical diagnosis among the patients in this cohort. Other reasons include varying caregiver thresholds for seeking medical help and the wide range of primary care physicians and specialists contacted by this cohort and their caregivers. It is noteworthy that, in most instances, the caregiver was a spouse or child living with the patient. Drs. Boersma and Eefsting believe the gender differences reported in our study for age at diagnosis are most likely attributable to social, i.e., marital, status rather than to pathological factors. We agree that marital status does indeed contribute to the explanation for these observed differences. Information pertaining to the patients' marital status at the time of clinical diagnosis was collected. This data was available for 91% of the sample and is shown in Table 1, stratified by gender. Patients who were married at the time of clinical diagnosis were indeed diagnosed earlier than their nonmarried counterparts.