Diagnosing Dementia: Interrater Reliability Assessment and Accuracy of the NINCDS/ADRDA Criteria versus CERAD Histopathological Criteria for Alzheimer’s Disease

Hogervorst, Eef; Barnetson, L.; Jobst, K; Nagy, Zsuzsanna; Combrinck, Marc; Smith, A.D.

doi:10.1159/000017222

Cited by 45 publications

(41 citation statements)

References 18 publications

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“…The fact that total oestradiol levels were significantly higher in AD cases in our study probably reflects, additionally, its greater power due to its larger size. Finally, our clinical assessment has shown high validity when compared with the post-mortem confirmed diagnosis of AD (33) and more than half the cases of the present study had post-mortem confirmation of Alzheimer pathology. This further increases our confidence in our own results: overall then, we conclude, in contrast to most previous studies, that oestradiol levels are higher in women with AD than in age-matched controls.…”

Section: Discussionsupporting

confidence: 50%

Measuring serum oestradiol in women with Alzheimer's disease: the importance of the sensitivity of the assay method

Hogervorst¹,

Williams²,

Combrinck³

et al. 2003

European Journal of Endocrinology

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Objective: Oestrogens could be protective against the development of Alzheimer's disease (AD) but reports on oestrogen levels in AD have been conflicting. Design and methods: A meta-analysis using robust regression was carried out to assess whether the sensitivity of the assays of past studies had affected the reported level of total oestradiol. We had also measured total oestradiol in women with AD ðn ¼ 66Þ and controls ðn ¼ 62Þ not using hormone replacement therapy. We used two assays for total oestradiol to assess the difference between sensitive (radioimmunoassay with a specific rabbit antibody: 3 pmol/l) and relatively insensitive (immunoassay: 37 pmol/l) assays. Results: Meta-analysis using robust regression indicated that insensitive assays gave higher levels of total oestradiol when many samples fall below the level of sensitivity of the method. Earlier reports of low levels of total oestradiol in AD might be explained by this phenomenon, since total oestradiol levels (using the sensitive assay) in our controls were one third of those reported in the earlier studies. Using the sensitive assay we found that women with AD had significantly ðP , 0:01Þ higher levels ð26^13 pmol=lÞ of total oestradiol than controls ð21^13 pmol=lÞ: Using the insensitive assay, there was no significant difference in the levels of total oestradiol. Conclusions: The sensitivity of the assay determines the reported value of the oestradiol levels. Studies using a sensitive assay do not report significantly lower levels of total oestradiol in women with AD. This weighs against the hypothesis that low levels of total oestradiol are a risk factor for AD.

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Section: Discussionsupporting

confidence: 50%

Measuring serum oestradiol in women with Alzheimer's disease: the importance of the sensitivity of the assay method

Hogervorst¹,

Williams²,

Combrinck³

et al. 2003

European Journal of Endocrinology

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“…DSM-IV criteria were used to establish a clinical diagnosis of dementia [14] in the absence of delirium and regardless of the length and stage of dementia [15]. AD was diagnosed according to the criteria of the NINCDS-ADRDA work group [16,17]. Subjects matching the DSM-IV but not the NINCDS-ADRDA criteria were considered as NAD.…”

Section: Methodsmentioning

confidence: 99%

Serum Vitamin D Deficiency as a Predictor of Incident Non-Alzheimer Dementias: A 7-Year Longitudinal Study

Annweiler

Rolland

Schott

et al. 2011

Dement Geriatr Cogn Disord

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Background: Hypovitaminosis D has been cross-sectionally associated with dementia and stroke. The objective of this longitudinal study was to determine whether serum vitamin D deficiency at baseline could predict the onset of non-Alzheimer dementias (NAD) within 7 years among older women. Methods: Forty high-functioning older women (78.4 years, 76.4/82.0; median, 25th/75th percentile) from the EPIDOS Toulouse study were divided into two groups based on vitamin D deficiency (i.e., serum 25-hydroxyvitamin D <10 ng/ml) at baseline. At the end of the 7-year follow-up period, women matching the DSM-IV but not the NINCDS-ADRDA criteria were diagnosed with NAD while those matching the NINCDS-ADRDA criteria were considered to have Alzheimer’s disease (AD). Subtle cognitive impairments at baseline, cardiovascular risk factors and Parkinson’s disease were used as potential confounders. Results: NAD was reported in 6 women (82.8 years, 80.6/86.0) after 7 years of follow-up. More NAD were observed in women with vitamin D deficiency (p = 0.023). There was no between-group difference regarding the onset of AD (p = 0.332). We found an association between vitamin D deficiency at baseline and the onset of NAD (adjusted odds ratio = 19.57, p = 0.042). Conversely, vitamin D deficiency was not associated with AD (p = 0.222). Conclusion: Baseline vitamin D deficiency predicted the onset of NAD within 7 years among older women.

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“…In clinical-pathological series, the NINCDS-ADRDA criteria 1 show a diagnostic accuracy of 80-95% 3 , and thus other procedures with diagnostic value for Alzheimer's disease require accuracy increments above these levels.…”

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confidence: 99%

Quantitative electroencephalography power and coherence measurements in the diagnosis of mild and moderate Alzheimer's disease

Fonseca

Tedrus

Prandi

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: To evaluate the contribution of quantitative electroencephalographic (qEEG) analyses in the diagnosis of Alzheimer's disease (AD). Method: Thirty-five patients from the Neurology Outpatients Clinic of PUC-Campinas, diagnosed with AD according to the NINCDS/ADRDA were evaluated, and compared with a control group consisting of 30 individuals with no cognitive deficit. The procedures consisted of clinical-neurological, cognitive and behavioral analyses and the qEEG (absolute power and coherence). Results: The AD group presented greater absolute power values in the delta and theta bands, greater theta/alpha indices and less frontal alpha and beta coherence. Logistic multiple regression models were constructed and those only showing variations in the qEEG (frontal alpha coherence and left frontal absolute theta power) showed an accuracy classification (72.3%) below that obtained in the mini-mental state examination (93%). Conclusion: The study of coherence and power in the qEEG showed a relatively limited accuracy with respect to its application in routine clinical practice. Key words: dementia, Alzheimer's disease, electroencephalography, EEG, coherence.Medidas de coerência e de potência absoluta no eletrencefalograma quantitativo no diagnóstico da doença de Alzheimer RESUMO Objetivo: Avaliar a contribuição das análises quantitativas do eletroencefalograma (qEEG) no diagnóstico da doença de Alzheimer (DA). Método: Foram avaliados 35 pacientes do ambulatório de Neurologia Clínica da PUC-Campinas, com o diagnóstico de DA segundo o NINCDS/ADRDA e comparados a 30 indivíduos, sem déficit cognitivo, de grupo controle. Os procedimentos foram avaliação clínico-neurológica, cognitiva e comportamental e EEGq (potência absoluta e coerência). Resultados: O grupo DA apresentou maiores potências absolutas nas faixas delta e teta, maiores índices teta/alfa e menor coerência alfa e beta frontal. Foram construídos modelos de regressão múltipla logística e aquele que contou apenas com variáveis do EEGq (coerência alfa frontal e potência absoluta teta frontal esquerda) teve acurácia de classificação (72,3%), inferior à obtida com o mini-exame do estado mental (93%). Conclusão: O estudo de coerência e potência no qEEG tem acurácia relativamente limitada no sentido de aplicação prática clínica rotineira. Palavras-chave: demência, doença de Alzheimer, eletroencefalografia, EEG, coerência, potência absoluta.

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Diagnosing Dementia: Interrater Reliability Assessment and Accuracy of the NINCDS/ADRDA Criteria versus CERAD Histopathological Criteria for Alzheimer’s Disease

Cited by 45 publications

References 18 publications

Measuring serum oestradiol in women with Alzheimer's disease: the importance of the sensitivity of the assay method

Measuring serum oestradiol in women with Alzheimer's disease: the importance of the sensitivity of the assay method

Serum Vitamin D Deficiency as a Predictor of Incident Non-Alzheimer Dementias: A 7-Year Longitudinal Study

Quantitative electroencephalography power and coherence measurements in the diagnosis of mild and moderate Alzheimer's disease

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