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Table of Contents
Vol. 27, No. 3, 2006
Issue release date: October 2006
Section title: Methods in Neuroepidemiology
Neuroepidemiology 2006;27:169–176

Decision Rules Guiding the Clinical Diagnosis of Alzheimer’s Disease in Two Community-Based Cohort Studies Compared to Standard Practice in a Clinic-Based Cohort Study

Bennett D.A.a, b · Schneider J.A.a-c · Aggarwal N.T.a, b · Arvanitakis Z.a, b · Shah R.C.a, e · Kelly J.F.a, f · Fox J.H.b · Cochran E.J.c · Arends D.a · Treinkman A.D.a · Wilson R.S.a, b, d
aRush Alzheimer’s Disease Center and Departments of bNeurological Sciences, cPathology, dBehavioral Sciences, eFamily Practice and fInternal Medicine, Rush University Medical Center, Chicago, Ill., USA
email Corresponding Author

David A. Bennett, MD

Rush Alzheimer’s Disease Center

600 South Paulina, Suite 1028

Chicago, IL 60612 (USA)

Tel. +1 312 942 2362, E-Mail dbennett@rush.edu

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We developed prediction rules to guide the clinical diagnosis of Alzheimer’s disease (AD) in two community-based cohort studies (the Religious Orders Study and the Rush Memory and Aging Project). The rules were implemented without informant interviews, neuroimaging, blood work or routine case conferencing. Autopsies were performed at death and the pathologic diagnosis of AD made with a modified version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) criteria. We compared the positive predictive value of the clinical diagnosis in the two community-based studies to the positive predictive value of the clinical diagnosis of AD made by standard clinical practice in a clinic-based cohort study using AD pathology as the gold standard. Of 306 clinic cases with probable AD, 286 (93.5%) met CERAD neuropathologic criteria for AD; the results were comparable for those with possible AD (51 of 54, 94.4%). Of 141 study subjects with probable AD, 130 (92.2%) met CERAD neuropathologic criteria for AD; the results were lower but acceptable for those with possible AD (26 of 37, 70.3%). The results were similar in secondary analyses using alternate neuropathologic criteria for AD. The clinical diagnosis of AD can be made in community-based studies without the use of informant interviews, neuroimaging, blood work or routine case conferencing. This approach holds promise for reducing the operational costs of epidemiologic studies of aging and AD.

© 2006 S. Karger AG, Basel

Article / Publication Details

First-Page Preview
Abstract of Methods in Neuroepidemiology

Received: July 19, 2006
Published online: October 27, 2006
Issue release date: October 2006

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED

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