Neuroepidemiology 2006;27:169–176
(DOI:10.1159/000096129)

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


 goto top of outline Key Words

  • Alzheimer’s disease
  • Alzheimer’s disease, diagnosis
  • Decision rules
  • Alzheimer’s disease, pathology

 goto top of outline Abstract

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.

Copyright © 2006 S. Karger AG, Basel


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 goto top of outline Author Contacts

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


 goto top of outline Article Information

Published online: October 10, 2006
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 3, Number of References : 56


 goto top of outline Publication Details

Neuroepidemiology

Vol. 27, No. 3, Year 2006 (Cover Date: October 2006)

Journal Editor: Román, G.C. (San Antonio, Tex.)
ISSN: 0251–5350 (print), 1423–0208 (Online)

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


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