Ascertainment Bias in the Clinical Diagnosis of Alzheimer Disease

Certified normal: Alzheimer's disease biomarkers and normative estimates of cognitive functioning

“…Even with the most optimal combinations of sensitivity and specificity, as seen on the FCSRT total recall using Robust norms, a clinical diagnosis based on cutoff scores on cognitive tests was incorrect in nearly 30 percent of cases (Table 7). This finding is also consistent with our prior report using a much smaller autopsy-confirmed cohort (Storandt and Morris, 2010). …”

Certified normal: Alzheimer's disease biomarkers and normative estimates of cognitive functioning

“…Even with the most optimal combinations of sensitivity and specificity, as seen on the FCSRT total recall using Robust norms, a clinical diagnosis based on cutoff scores on cognitive tests was incorrect in nearly 30 percent of cases (Table 7). This finding is also consistent with our prior report using a much smaller autopsy-confirmed cohort (Storandt and Morris, 2010). …”

Cognitive Declines Precede and Predict Functional Declines in Aging and Alzheimer’s Disease

“…It is notable that a previous study reporting poor prognostic ability of neuropsychological tests did not examine cognitive abilities assessed in the present study: word list learning, basic language ability, and verbal abstraction [11]. Together, these results support the importance of assessing memory and language with tests that require greater executive demands to detect the earliest deficits of AD [26].…”

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

“…Both of these tasks demonstrated strong specificity (100 and 96, respectively) and sensitivity (86%), meeting the recommended cutoff of 80% (Consensus Workgroup 1998). Storandt and Morris (2010) reported lower than expected values for both sensitivity (62%) and specificity (70%) on the WMS Associate Learning Immediate Recall task. Though they reported multiple cutoff values in the article, a standard deviation of −0.5 was the best balance between sensitivity and specificity.…”

“…See online resources (Tables i and ii) for additional information about diagnostic criteria applied by each study. In summary, over half (54%) of the AD studies (included in both AD versus HC and AD versus Other; k = 29 of 54) included “probable” AD diagnoses only (i.e., excluded “possible AD” participants), 23%(k = 12) included both probable and possible AD diagnoses, k = 2 included confirmatory autopsy data (Salmon et al 2002; Storandt and Morris 2010), one used familial gene sequence (Parra et al 2010), and 19% (k = 10) did not specify probable or possible AD diagnoses.…”

Certified normal: Alzheimer's disease biomarkers and normative estimates of cognitive functioning

“…Even with the most optimal combinations of sensitivity and specificity, as seen on the FCSRT total recall using Robust norms, a clinical diagnosis based on cutoff scores on cognitive tests was incorrect in nearly 30 percent of cases (Table 7). This finding is also consistent with our prior report using a much smaller autopsy-confirmed cohort (Storandt and Morris, 2010). …”

Cognitive Declines Precede and Predict Functional Declines in Aging and Alzheimer’s Disease

“…It is notable that a previous study reporting poor prognostic ability of neuropsychological tests did not examine cognitive abilities assessed in the present study: word list learning, basic language ability, and verbal abstraction [11]. Together, these results support the importance of assessing memory and language with tests that require greater executive demands to detect the earliest deficits of AD [26].…”

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

“…Both of these tasks demonstrated strong specificity (100 and 96, respectively) and sensitivity (86%), meeting the recommended cutoff of 80% (Consensus Workgroup 1998). Storandt and Morris (2010) reported lower than expected values for both sensitivity (62%) and specificity (70%) on the WMS Associate Learning Immediate Recall task. Though they reported multiple cutoff values in the article, a standard deviation of −0.5 was the best balance between sensitivity and specificity.…”

“…See online resources (Tables i and ii) for additional information about diagnostic criteria applied by each study. In summary, over half (54%) of the AD studies (included in both AD versus HC and AD versus Other; k = 29 of 54) included “probable” AD diagnoses only (i.e., excluded “possible AD” participants), 23%(k = 12) included both probable and possible AD diagnoses, k = 2 included confirmatory autopsy data (Salmon et al 2002; Storandt and Morris 2010), one used familial gene sequence (Parra et al 2010), and 19% (k = 10) did not specify probable or possible AD diagnoses.…”

Certified normal: Alzheimer's disease biomarkers and normative estimates of cognitive functioning

“…Even with the most optimal combinations of sensitivity and specificity, as seen on the FCSRT total recall using Robust norms, a clinical diagnosis based on cutoff scores on cognitive tests was incorrect in nearly 30 percent of cases (Table 7). This finding is also consistent with our prior report using a much smaller autopsy-confirmed cohort (Storandt and Morris, 2010). …”

Cognitive Declines Precede and Predict Functional Declines in Aging and Alzheimer’s Disease

“…It is notable that a previous study reporting poor prognostic ability of neuropsychological tests did not examine cognitive abilities assessed in the present study: word list learning, basic language ability, and verbal abstraction [11]. Together, these results support the importance of assessing memory and language with tests that require greater executive demands to detect the earliest deficits of AD [26].…”

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

“…Both of these tasks demonstrated strong specificity (100 and 96, respectively) and sensitivity (86%), meeting the recommended cutoff of 80% (Consensus Workgroup 1998). Storandt and Morris (2010) reported lower than expected values for both sensitivity (62%) and specificity (70%) on the WMS Associate Learning Immediate Recall task. Though they reported multiple cutoff values in the article, a standard deviation of −0.5 was the best balance between sensitivity and specificity.…”

“…See online resources (Tables i and ii) for additional information about diagnostic criteria applied by each study. In summary, over half (54%) of the AD studies (included in both AD versus HC and AD versus Other; k = 29 of 54) included “probable” AD diagnoses only (i.e., excluded “possible AD” participants), 23%(k = 12) included both probable and possible AD diagnoses, k = 2 included confirmatory autopsy data (Salmon et al 2002; Storandt and Morris 2010), one used familial gene sequence (Parra et al 2010), and 19% (k = 10) did not specify probable or possible AD diagnoses.…”