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Vol. 30, No. 4, 2008
Issue release date: June 2008
Free Access
Neuroepidemiology 2008;30:254–265
(DOI:10.1159/000135644)

Development of Screening Guidelines and Clinical Criteria for Predementia Alzheimer’s Disease

The DESCRIPA Study

Visser P.J.a, b · Verhey F.R.J.a · Boada M.d · Bullock R.e · De Deyn P.P.h · Frisoni G.B.i · Frölich L.k · Hampel H.l-n · Jolles J.a · Jones R.f · Minthon L.o · Nobili F.j · Olde Rikkert M.c · Ousset P.-J.q · Rigaud A.-S.r · Scheltens P.b · Soininen H.t · Spiru L.u · Touchon J.s · Tsolaki M.v · Vellas B.q · Wahlund L.-O.p · Wilcock G.g · Winblad B.p
aDepartment of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, bDepartment of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, and cDepartment of Geriatrics, Radboud University Medical Centre, Nijmegen, The Netherlands; dFundació ACE, Barcelona, Spain; eKingshill Research Centre, Swindon, fThe Research Institute for the Care of Older People, Bath, and gDepartment of Care of Elderly, University of Bristol, Frenchay Hospital, Bristol, UK; hInstitute Born Bunge, ZNA Middelheim, University of Antwerp, Antwerp, Belgium; iLENITEM, IRCCS Fatebenefratelli, Brescia, and jClinical Neurophysiology Service Unit, Department of Endocrinological and Metabolic Sciences, University of Genoa, Genoa, Italy; kDivision of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, and lAlzheimer Memorial Centre and Geriatric Psychiatry Branch, Dementia and Neuroimaging Section Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany; mDiscipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Trinity Centre for Health Sciences, and nThe Adelaide and Meath Hospital Incorporating The National Children’s Hospital, Dublin, Ireland; oClinical Memory Research Unit, Department of Clinical Sciences Malmö Lund University, Lund, and pNVS Department, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden; qDepartment of Internal Medicine and Clinical Gerontology, Toulouse University Hospital, Toulouse, rDepartment of Geriatrics, Hopital Broca, Paris, and sInstitute National de la Santé et de la Recherche Medicinale INSERM U 888, Montpellier, France; tDepartment of Neurology, University and University Hospital of Kuopio, Kuopio, Finland; u‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania; vAristotle University of Thessaloniki, Memory and Dementia Centre, G. Papanicolaore General Hospital, Thessaloniki, Greece
email Corresponding Author

Abstract

Background: There is an urgent need to identify subjects with Alzheimer’s disease (AD) in the predementia phase, but validated diagnostic approaches are currently lacking. In this paper, we present the background, design and methods of a study, which aims to develop clinical criteria for predementia AD. We also present baseline characteristics of the subjects included. The study was part of the multicentre DESCRIPA project, which is being conducted within the network of the European Alzheimer’s Disease Consortium. Methods: Clinical criteria will be based on a prospective cohort study of non-demented subjects older than 55 years and referred to a memory clinic. At baseline, a number of markers and risk factors for AD were collected, including demographic variables, measures of performance in activities of daily living, cognitive, neuroimaging and genetic markers, and serum and cerebrospinal fluid markers. Subjects will be reassessed annually for 2–3 years, and we will evaluate which combination of variables best predicts AD-type dementia at follow-up. Results: Between 2003 and 2005, 881 subjects were included from 20 memory clinics. Subjects were on average 70.3 years old, and had 10.4 years of education. The average score on the Mini-Mental State Examination was 27.4.


 goto top of outline Key Words

  • Alzheimer’s disease, diagnosis
  • Mild cognitive impairment, elderly
  • Study, longitudinal cohort, observational, multicentre

 goto top of outline Abstract

Background: There is an urgent need to identify subjects with Alzheimer’s disease (AD) in the predementia phase, but validated diagnostic approaches are currently lacking. In this paper, we present the background, design and methods of a study, which aims to develop clinical criteria for predementia AD. We also present baseline characteristics of the subjects included. The study was part of the multicentre DESCRIPA project, which is being conducted within the network of the European Alzheimer’s Disease Consortium. Methods: Clinical criteria will be based on a prospective cohort study of non-demented subjects older than 55 years and referred to a memory clinic. At baseline, a number of markers and risk factors for AD were collected, including demographic variables, measures of performance in activities of daily living, cognitive, neuroimaging and genetic markers, and serum and cerebrospinal fluid markers. Subjects will be reassessed annually for 2–3 years, and we will evaluate which combination of variables best predicts AD-type dementia at follow-up. Results: Between 2003 and 2005, 881 subjects were included from 20 memory clinics. Subjects were on average 70.3 years old, and had 10.4 years of education. The average score on the Mini-Mental State Examination was 27.4.

Copyright © 2008 S. Karger AG, Basel


 goto top of outline References
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  2. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work-Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 1984;34:939–944.
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 goto top of outline Author Contacts

Pieter Jelle Visser
Department of Psychiatry and Neuropsychology, University of Maastricht
PO Box 616
NL–6200 MD Maastricht (The Netherlands)
Tel. +31 20 617 1721, Fax +31 842 134 161, E-Mail pj.visser@np.unimaas.nl


 goto top of outline Article Information

Received: January 23, 2008
Accepted: March 2, 2008
Published online: June 2, 2008
Number of Print Pages : 12
Number of Figures : 0, Number of Tables : 5, Number of References : 74


 goto top of outline Publication Details

Neuroepidemiology

Vol. 30, No. 4, Year 2008 (Cover Date: June 2008)

Journal Editor: Feigin V.L. (Auckland)
ISSN: 0251–5350 (Print), eISSN: 1423–0208 (Online)

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


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Background: There is an urgent need to identify subjects with Alzheimer’s disease (AD) in the predementia phase, but validated diagnostic approaches are currently lacking. In this paper, we present the background, design and methods of a study, which aims to develop clinical criteria for predementia AD. We also present baseline characteristics of the subjects included. The study was part of the multicentre DESCRIPA project, which is being conducted within the network of the European Alzheimer’s Disease Consortium. Methods: Clinical criteria will be based on a prospective cohort study of non-demented subjects older than 55 years and referred to a memory clinic. At baseline, a number of markers and risk factors for AD were collected, including demographic variables, measures of performance in activities of daily living, cognitive, neuroimaging and genetic markers, and serum and cerebrospinal fluid markers. Subjects will be reassessed annually for 2–3 years, and we will evaluate which combination of variables best predicts AD-type dementia at follow-up. Results: Between 2003 and 2005, 881 subjects were included from 20 memory clinics. Subjects were on average 70.3 years old, and had 10.4 years of education. The average score on the Mini-Mental State Examination was 27.4.



 goto top of outline Author Contacts

Pieter Jelle Visser
Department of Psychiatry and Neuropsychology, University of Maastricht
PO Box 616
NL–6200 MD Maastricht (The Netherlands)
Tel. +31 20 617 1721, Fax +31 842 134 161, E-Mail pj.visser@np.unimaas.nl


 goto top of outline Article Information

Received: January 23, 2008
Accepted: March 2, 2008
Published online: June 2, 2008
Number of Print Pages : 12
Number of Figures : 0, Number of Tables : 5, Number of References : 74


 goto top of outline Publication Details

Neuroepidemiology

Vol. 30, No. 4, Year 2008 (Cover Date: June 2008)

Journal Editor: Feigin V.L. (Auckland)
ISSN: 0251–5350 (Print), eISSN: 1423–0208 (Online)

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


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Ott A, Breteler M, van Harskamp F, Claus J, van der Cammen T, Grobbee D, Hofman A: Prevalence of Alzheimer’s disease and vascular dementia: association with education. The Rotterdam Study. BMJ 1995;310:970–973.
  2. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work-Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 1984;34:939–944.
  3. Dubois B, Feldman HH, Jacova C, Dekosky ST, Barberger-Gateau P, Cummings J, Delacourte A, Galasko D, Gauthier S, Jicha G, Meguro K, O’Brien J, Pasquier F, Robert P, Rossor M, Salloway S, Stern Y, Visser PJ, Scheltens P: Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 2007;6:734–746.
  4. Visser P: Mild cognitive impairment; in Pathy MSJ, Morley JE, Sinclair A (eds): Principles and Practice of Geriatric Medicine. London, John Wiley & Sons, 2006, pp 1095–1103.
  5. Visser PJ, Verhey FRJ, Scheltens P, Cruts M, Ponds RWHM, Hofman PAM, Van Broeckhoven CM, Jolles J: Diagnostic accuracy of the Preclinical AD Scale (PAS) in cognitively mildly impaired subjects. J Neurol 2002;249:312–319.
  6. Devanand DP, Pradhaban G, Liu X, Khandji A, De Santi S, Segal S, Rusinek H, Pelton GH, Honig LS, Mayeux R, Stern Y, Tabert MH, de Leon MJ: Hippocampal and entorhinal atrophy in mild cognitive impairment: prediction of Alzheimer disease. Neurology 2007;68:828–836.
  7. Fleisher AS, Sowell BB, Taylor C, Gamst AC, Petersen RC, Thal LJ: Clinical predictors of progression to Alzheimer disease in amnestic mild cognitive impairment. Neurology 2007;68:1588–1595.
  8. Wilson RS, Bennett DA, Bienias JL, Mendes de Leon CF, Morris MC, Evans DA: Cognitive activity and cognitive decline in a biracial community population. Neurology 2003;61:812–816.
  9. Folstein MF, Folstein SE, McHugh PR: ‘Mini-Mental State’, a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  10. Blessed G, Tomlinson BE, Roth M: The association between quantitative measures of dementia and of senile changes in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968;114:797–811.
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  12. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185:914–919.
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