Evaluation of Selection Bias in an Incident-Based Dementia Autopsy Case Series
Open accessAbstract
Neuropathological (np) relative frequency estimates of dementia may be biased if the autopsied subjects are not representative of all dementia subjects within a target population. We identified characteristics that differed between autopsied and non-autopsied subjects from an incident-based dementia case series and compared autopsy-based estimates of the relative frequency of np diagnoses before and after adjusting for potential selection bias. Clinically demented subjects who were autopsied (n = 206), had died but were not autopsied (n = 271), were still alive (n = 71), or had dropped out of the study (n = 82) were included. Compared with non-autopsied subjects, autopsied subjects were more likely to be Caucasian, educated beyond high school, and married. They also tended to have a lower baseline Mini-Mental State Examination score and were more likely to have a clinical diagnosis of Alzheimer disease (AD) than non-autopsied subjects. Neuropathological AD with Lewy bodies (LB) had the largest crude relative frequency estimate at 38% of the autopsy sample, followed by 25% for AD with vascular lesions, 13% for pure AD, 13% for LB (with or without vascular lesions), and 8% for pure vascular pathologies. Adjustment for potential sources of selection bias had little effect on relative frequency estimates, suggesting that np diagnoses in the autopsied subjects provide reasonable dementia relative frequency estimates among all clinically demented cases in this series.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
One study has reported no evident selection bias between autopsied and non-autopsied subjects among an incident community-diagnosed dementia series, suggesting that dementia case composition may not be substantially different in different settings.
“However, one study has reported no evident selection bias between autopsied and non-autopsied subjects among an incident community-diagnosed dementia series, suggesting that dementia case composition may not be substantially different in different settings (48).”
From Accuracy of the Clinical Diagnosis of Alzheimer Disease at National Institute on Aging Alzheimer Disease Centers, 2005–2010 (2012) · cites this paper as [48]
Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredSample selection in incident-based dementia autopsy series has an effect (a caveat).
“A specific caveat in this respect is the effect of sample selection in incident-bases dementia autopsy series [164].”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [164]
Community samples tend to show greater degrees of cerebrovascular pathology compared to hospital-based samples.
“Community samples tend to show greater degrees of cerebrovascular pathology as compared to hospital based samples; and the prevalence of mixed AD/CVD was higher in the community-based RUSH Memory and Aging Project (44%) than in the RUSH Religious Order Study (28%).”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [164]
The prevalence of mixed AD/CVD was higher in the community-based RUSH Memory and Aging Project (44%) than in the RUSH Religious Order Study (28%).
“Community samples tend to show greater degrees of cerebrovascular pathology as compared to hospital based samples; and the prevalence of mixed AD/CVD was higher in the community-based RUSH Memory and Aging Project (44%) than in the RUSH Religious Order Study (28%).”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [164]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984) · Neurology · doi:10.1212/wnl.34.7.939 · Cited by 27,915 · see citing works
Hamilton, R. L. (2000) · Brain Pathology · doi:10.1111/j.1750-3639.2000.tb00269.x · Cited by 754 · see citing works
Clinico‐Neuropathological Correlation of Alzheimer's Disease in a Community‐Based Case Series
Lim, A., Tsuang, D. W., Kukull, W. A., Nochlin, D., Leverenz, J. B., McCormick, W. C., Bowen, J., Teri, L. L., Thompson, J. C., Peskind, E. R., et al. (1999) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb02571.x · Cited by 450 · see citing works
Self-citationPrevalence of Dementia in Older Japanese-American Men in Hawaii: The Honolulu-Asia Aging Study
White, L. (1996) · JAMA · doi:10.1001/jama.1996.03540120033030 · Cited by 437 · see citing works
Increased prevalence of vascular dementia in Japan
Ikeda, M., Hokoishi, K., Maki, N., Nebu, A., Tachibana, N., Komori, K., Shigenobu, K., Fukuhara, R., & Tanabe, H. (2001) · Neurology · doi:10.1212/wnl.57.5.839 · Cited by 170 · see citing works
Fallacies in the pathological confirmation of the diagnosis of Alzheimer’s disease
Bowler, J., Muñoz, D., Merskey, H., & Hachinski, V. (1998) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.64.1.18 · Cited by 148 · see citing works
Absence of Vascular Dementia in an Autopsy Series from a Dementia Clinic
Nolan, K. A., Lino, M. M., Seligmann, A. W., & Blass, J. P. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb01076.x · Cited by 130 · see citing works
Frequency of Alzheimer's Disease and Other Dementias in a Community Outreach Sample of Hispanics
Fitten, L. J., Ortiz, F., & Pontón, M. O. (2001) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2001.49257.x · Cited by 110 · see citing works
Effect of Vascular Lesions on Cognition in Alzheimer's Disease: A Community‐Based Study
Riekse, R. G., Leverenz, J. B., McCormick, W. C., Bowen, J. D., Teri, L. L., Nochlin, D., Simpson, K., Eugenio, C. J., Larson, E. B., & Tsuang, D. W. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52405.x · Cited by 109 · see citing works
Self-citationTsuang, D., Kukull, W., Sheppard, L., Barnhart, R. L., Peskind, E., Edland, S. D., Schellenberg, G., Raskind, M., & Larson, E. B. (1996) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1996.tb01836.x · Cited by 69 · see citing works
Self-citationUniversity of Washington Alzheimer's Disease Patient Registry (ADPR): 1987-1988.
Larson, E. B., Kukull, W. A., Teri, L. L., McCormick, W. C., Pfanschmidt, M. L., van Belle, G., & Sumi, M. (1990) · PubMed · Cited by 68 · see citing works
Self-citationFamilial Dementia With Lewy Bodies
Tsuang, D. W., Dalan, A. M., Eugenio, C. J., Poorkaj, P., Limprasert, P., Spada, A. R. L., Steinbart, E. J., Bird, T. D., & Leverenz, J. B. (2002) · Archives of Neurology · doi:10.1001/archneur.59.10.1622 · Cited by 67 · see citing works
Self-citationApolipoprotein E in Alzheimer's disease risk and case detection: A case-control study
Kukull, W. A., Schellenberg, G. D., Bowen, J. D., McCormick, W. C., Yu, C., Teri, L. L., Thompson, J. D., O’Meara, E. S., & Larson, E. B. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(96)00195-3 · Cited by 58 · see citing works
Self-citationA discriminant analysis extension to mixed models
Tomasko, L., Helms, R. W., & Snapinn, S. M. (1999) · Statistics in Medicine · doi:10.1002/(sici)1097-0258(19990530)18:10 · Cited by 55 · see citing works
Autopsy Recruitment Program for African Americans
Bonner, G. J., Darkwa, O. K., & Gorelick, P. B. (2000) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-200010000-00003 · Cited by 45 · see citing works
Geographically Overlapping Alzheimer's Disease Registries: Comparisons and Implications
Barnhart, R. L., van Belle, G., Edland, S. D., Kukull, W. A., Soo Borson, B., Raskind, M. A., Teri, L. L., McLean, P., & Larson, E. B. (1995) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/089198879500800401 · Cited by 29 · see citing works
Self-citationThe Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part XIII.
Fillenbaum, G. G., Huber, M. S., Beekly, D. L., Henderson, V. W., Mortimer, J. A., Morris, J. C., & Harrell, L. E. (1996) · Neurology · doi:10.1212/wnl.46.1.142 · Cited by 28 · see citing works
Fontoura-da-Silva, S. E., & Chautard‐Freire‐Maia, E. A. (1996) · Human Heredity · doi:10.1159/000154343 · Cited by 25 · see citing works
Harrell, L. E., Callaway, R., & Powers, R. E. (1993) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-199307020-00003 · Cited by 23 · see citing works
Shadlen, M., Larson, E. B., & Yukawa, M. (2000) · Neurobiology of Aging · doi:10.1016/s0197-4580(00)00115-9 · Cited by 22 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Beach, T. G., Monsell, S. E., Phillips, L. E., & Kukull, W. (2012) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/nen.0b013e31824b211b · Cited by 1,103 · see citing works
“However, one study has reported no evident selection bias between autopsied and nonautopsied subjects among an incident community-diagnosed dementia series, suggesting that dementia case composition may not be substantially different in different settings (48).”
BackgroundThe overlap between vascular disease and Alzheimer’s disease - lessons from pathology
Attems, J., & Jellinger, K. A. (2014) · BMC Medicine · doi:10.1186/s12916-014-0206-2 · Cited by 739 · see citing works
“A specific caveat in this respect is the effect of sample selection in incident-bases dementia autopsy series [164].”
BackgroundPathological correlates of dementia in a longitudinal, population‐based sample of aging
Sonnen, J. A., Larson, E. B., Crane, P. K., Haneuse, S., Li, G., Schellenberg, G. D., Craft, S., Leverenz, J. B., & Montine, T. J. (2007) · Annals of Neurology · doi:10.1002/ana.21208 · Cited by 432 · see citing works
Self-citationRelative preservation of MMSE scores in autopsy-proven dementia with Lewy bodies
Nelson, P. T., Kryscio, R. J., Jicha, G. A., Abner, E. L., Schmitt, F. A., Xu, L. O., Cooper, G., Smith, C. D., & Markesbery, W. R. (2009) · Neurology · doi:10.1212/wnl.0b013e3181bacf9e · Cited by 99 · see citing works
- Authors
- Tsuang, D., Simpson, K. L., Li, G., Barnhart, R. L., Edland, S. D., Bowen, J., McCormick, W., Teri, L., Nochlin, D., Larson, E. B., Thompson, M. L., & Leverenz, J. B.
- Affiliations
- University of Washington (US)
- Mayo Clinic (US)
- Mental Illness Research, Education and Clinical Centers (US)
- Corresponding author
- Tsuang, Debby
- Simpson, Kate L
- Li, Gail
- Teri, Linda
- Leverenz, James B
- Venue
- Alzheimer Disease & Associated Disorders
- Published
- 2005-04
- Volume
- 19
- Issue
- 2
- Pages
- 67-73
- ISSN
- 0893-0341 (ISSN-L)
- PMC
- PMC1524825
- OpenAlex
- W2063879864
- Cited by
- 37
- References
- 20
- Citations by year
- 2024: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer Disease & Associated Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (AG 05136, U01AG006781, AG-06781, P50AG005136)
- National Institute of Neurological Disorders and Stroke (R01NS048595, R01 NS48595)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- selection bias, dementia, neuropathological diagnosis, autopsy, Alzheimer's disease, Lewy bodies, vascular dementia, sample representativeness
- MeSH terms
- Aged, Aged, 80 and over, Analysis of Variance, Autopsy, Dementia, Female, Humans, Male, Registries, Selection Bias, Incidence, Chi-Square Distribution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
