We studied the time to institutionalization (or death as the first event) in 727 white patients with Alzheimer's disease (AD) enrolled in the Consortium to Establish a Registry for Alzheimer's disease (CERAD). At the time of analysis, 417 patients had been admitted to nursing homes and 32 others had died without previous institutionalization. The major predictors of time to first event were sex, age, marital status (men only), and severity of dementia at entry into the study, as measured by activities of daily living, the Mini-Mental State Examination, and the Clinical Dementia Rating scale. The overall median time from enrollment in the study to first event was 3.1 years. For unmarried men, the median time was significantly less (2.1 years) than for either married men or for married or unmarried women, all of whom had medians greater than 3 years. In an analysis of survival time following institutionalization, we found that men survived a median of 2.1 years, compared with 4.5 years for women. This nationwide study of AD largely confirms earlier studies that reported on smaller numbers of cases from local catchment areas and included patients with various types of dementia.