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A gradual deterioration of mental and physical condition is one of the main clinical signs of dementia of the Alzheimer type (DA T). To describe this deterioration, we evaluated 88 institutionalized patients with DA T and plotted their current status on a number of different clinical parameters as a function of time from the estimated onset of dementia. Ratings of speech, cooperation, social contact, and communication were in the very low range in patients with duration of DA T of three years or longer, while the rating of mood was similar regardless of duration of DA T. Half of the patients were unable to dress themselvesfive years after onset of symptoms and unable to sleep regularly six years after onset. By seven years 50% had developed rigidity on passive movement, and by eight years half were unable to feed themselves and to walk without assistance. By nine to ten years, 50% had developed contractures of the limbs and were mute, and by twelve years, half of those who survived had lost eye contact with caregivers.AUTHORS' NOTE: This study was supported by the Veterans Administration. We gratefully acknowledge the assistance of Paula Lyon, M.Ed., and members of the nursing staff, in the data collection. Requests for reprints should be sent to Dr.