The commonly used criteria for diagnosis can differ by a factor of 10 in the number of subjects classified as having dementia. Such disagreement has serious implications for research and treatment, as well as for the right of many older persons to drive, make a will, and handle financial affairs.

Hand preference is multidimensional with two major factors and a variable number of minor factors. In the present factor analyses of hand preference, there was no evidence to support Healey, Liederman and Geschwind's (1986) suggestion that hand preference dimensions can be distinguished on the basis of those requiring movement of the distal musculature (fingers and hand) and those requiring movement of the proximal. The first factor reported here relates to "skilled" activities. Hand preference for the use of tools and manipulation of other objects is strongly lateralized in self-professed right- and left-handers. "Less skilled" activities such as picking up objects load on a second and a third factor. Preference for picking up objects including very small ones and relatively heavy ones is much less lateralized, although there appears to be a distinction between activities that involve strength and those that do not. A fourth factor relates to the use of bats and axes, a bimanual activity.

This population-based study supported the importance of gender, age, functional status, cognition, and health status in predicting 5-year mortality, and after accounting for cognitive status, physical status, and specific disease variables, the difference in mortality between older people in the community and in institutions was reduced. Knowledge about survival and prognosis is important not only for the planning of long-term facilities and home care, but it can also be helpful for clinical decision-making and for family and caregivers.

Elderly with dementia have clearly increased mortality rates relative to elderly without cognitive impairment in all age/sex categories. People with vascular dementia have a particularly poor prognosis. Studies of AD and vascular dementia using death certificate data will grossly underestimate the proportions of elderly with these diseases.

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