Clinico‐Neuropathological Correlation of Alzheimer's Disease in a Community‐Based Case Series

Lim, Alfredo; Tsuang, Debby W.; Kukull, Walter A.; Nochlin, David; Leverenz, James B.; McCormick, Wayne C.; Bowen, James; Teri, Linda; Thompson, Jill D.; Peskind, Elaine R.; Raskind, Murray A.; Larson, Eric B.

doi:10.1111/j.1532-5415.1999.tb02571.x

Cited by 375 publications

(257 citation statements)

References 31 publications

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“…14, [46][47][48] Another possible interpretation of our data is that depression at baseline was secondary to dementia or was a prodromal symptom of early stage dementia. 4 Both vascular dementia and AD are associated with a higher prevalence of depression.…”

Section: Discussionmentioning

confidence: 96%

Comorbid Depression Is Associated with an Increased Risk of Dementia Diagnosis in Patients with Diabetes: A Prospective Cohort Study

et al. 2010

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Section: Discussionmentioning

confidence: 96%

Comorbid Depression Is Associated with an Increased Risk of Dementia Diagnosis in Patients with Diabetes: A Prospective Cohort Study

et al. 2010

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“…37 Although the sensitivity of these clinical criteria is rather high (80%), their specificity is o70% for probable AD. 38,39 This diagnostic uncertainty has a major impact on molecular diagnostic strategy and may lead to wrongly attribute a disease to a variant affecting function. To help solve this issue, it has been shown that the use of CSF biomarkers can improve the validity of clinical criteria.…”

Section: Discussionmentioning

confidence: 99%

Screening of dementia genes by whole-exome sequencing in early-onset Alzheimer disease: input and lessons

Nicolas¹,

Wallon²,

Charbonnier³

et al. 2015

Eur J Hum Genet

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Causative variants in APP, PSEN1 or PSEN2 account for a majority of cases of autosomal dominant early-onset Alzheimer disease (ADEOAD, onset before 65 years). Variant detection rates in other EOAD patients, that is, with family history of lateonset AD (LOAD) (and no incidence of EOAD) and sporadic cases might be much lower. We analyzed the genomes from 264 patients using whole-exome sequencing (WES) with high depth of coverage: 90 EOAD patients with family history of LOAD and no incidence of EOAD in the family and 174 patients with sporadic AD starting between 51 and 65 years. We found three PSEN1 and one PSEN2 causative, probably or possibly causative variants in four patients (1.5%). Given the absence of PSEN1, PSEN2 and APP causative variants, we investigated whether these 260 patients might be burdened with protein-modifying variants in 20 genes that were previously shown to cause other types of dementia when mutated. For this analysis, we included an additional set of 160 patients who were previously shown to be free of causative variants in PSEN1, PSEN2 and APP: 107 ADEOAD patients and 53 sporadic EOAD patients with an age of onset before 51 years. In these 420 patients, we detected no variant that might modify the function of the 20 dementia-causing genes. We conclude that EOAD patients with family history of LOAD and no incidence of EOAD in the family or patients with sporadic AD starting between 51 and 65 years have a low variant-detection rate in AD genes.

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“…[16][17][18] The criteria require memory impairment to be present, as well as deficits in one other cognitive domain (aphasia, apraxia, agnosia and executive dysfunctioning). Moreover, these cognitive declines must be of sufficient severity to cause perceptible impairment in social or occupational functioning (Table 2).…”

Section: Subjective Approachmentioning

confidence: 99%

Systematic review of recent dementia practice guidelines

2014

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Level Type of Evidence + +High quality meta-analyses, systematic reviews of randomised controlled trials (RCTs), or RCTs with a very low risk of bias. +Well conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias. -Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias + +High quality systematic reviews of case control or cohort studies. High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 + Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal -Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3Non-analytic studies, e.g. case reports, case series 4 Expert opinion Levels of evidence and grades of recommendation Statement of IntentThese guidelines are not intended to serve as a standard of medical care. Standards of medical care are determined on the basis of all clinical data available for an individual case and are subject to change as scientific knowledge advances and patterns of care evolve.The contents of this publication are guidelines to clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not ensure a successful outcome in every case. These guidelines should neither be construed as including all proper methods of care, nor exclude other acceptable methods of care. Each physician is ultimately responsible for the management of his/her unique patient, in the light of the clinical data presented by the patient and the diagnostic and treatment options available. ForewordDementia represents a major public health concern in Singapore and worldwide. Being the most prevalent neurodegenerative disease, dementia is expected to affect 55,000 patients in Singapore by the year 2020. The commonest cause of dementia is Alzheimer's disease with vascular dementia being the next most important cause. Right from the stage of mild dementia up to the stages of severe dementia, this condition poses a significant health and socio-economic burden to patients, caregivers and the nation as a whole. Early diagnosis will allow appropriate use of pharmacological and non-pharmacological management. Along with disease stabilization, efforts to address caregiver burden, patient safety and medico legal concerns should form the principles of management. Clear practise guidelines will allow holistic and optimal care in dementia.I am pleased to present the revised clinical practise guidelines for dementia. In this regard the workgroup has performed a thorough review of the existing literature to recommend both pharmacological and nonpharmacological aspects of management for patients ranging from mild cognitive impairment to severe dementia. This revised guidelines also highlights issues related to the management of mild cognitive impairment, young onset dementia and e...

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Clinico‐Neuropathological Correlation of Alzheimer's Disease in a Community‐Based Case Series

Abstract: This study of a large series of community-based incident dementia cases provides a way of judging the adequacy of currently available clinical diagnostic criteria. It also shows that co-existing neuropathological findings are common in community-based AD.

Cited by 375 publications

References 31 publications

Comorbid Depression Is Associated with an Increased Risk of Dementia Diagnosis in Patients with Diabetes: A Prospective Cohort Study

Comorbid Depression Is Associated with an Increased Risk of Dementia Diagnosis in Patients with Diabetes: A Prospective Cohort Study

Screening of dementia genes by whole-exome sequencing in early-onset Alzheimer disease: input and lessons

Systematic review of recent dementia practice guidelines

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