Staging of Alzheimer-Type Pathology: An Interrater-Intrarater Study
Abstract
The staging method proposed by Braak and Braak is based on the sequential accumulation of neurofibrillary pathology in the cerebral cortex. Unlike the currently used diagnostic criteria for Alzheimer's disease (AD) it does not take into consideration the age of the patients and whether they were demented or not for the establishment of the pathological stage of the disease. To examine the interobserver reliability of the method we performed an inter- and intrarater study using the Braak staging method in 41 brains. The agreement between the examiners and between the diagnoses of the same examiner at different times was almost perfect, the kappa statistics reaching values above 0.90. These findings indicate that the staging, relying on the differential distribution of neuritic pathology in the brain in AD, is a reliable and reproducible method for the description of AD-related pathology. This makes it suitable for brain-banking and research purposes.
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Nelson et al estimated that 18% of subjects with dementia fell outside of the NIA-Reagan guidelines.
“In a recent examination of NACC data, Nelson et al estimated that 18% of subjects with dementia fell outside of the NIA-Reagan guidelines (34);”
From Accuracy of the Clinical Diagnosis of Alzheimer Disease at National Institute on Aging Alzheimer Disease Centers, 2005–2010 (2012) · cites this paper as [34]
CERAD and Braak scoring methods have been shown to have a reasonably high level of reproducibility between observers and among research centers.
“These scoring methods have been shown to have a reasonably high level of reproducibility between observers and among research centers (34-37).”
From Accuracy of the Clinical Diagnosis of Alzheimer Disease at National Institute on Aging Alzheimer Disease Centers, 2005–2010 (2012) · cites this paper as [34]
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Cited by 45
- Authors
- Nagy, Z., Vatter-Bittner, B., Braak, H., Braak, E., Yilmazer, D. M., Schultz, C., & Hanke, J.
- Affiliations
- University of Oxford (GB)
- Goethe University Frankfurt (DE)
- Venue
- Dementia and Geriatric Cognitive Disorders
- Publisher
- S. Karger AG
- Published
- 1997-06-13
- Volume
- 8
- Issue
- 4
- Pages
- 248-251
- ISSN
- 1420-8008 (ISSN-L)
- 1421-9824
- OpenAlex
- W1974614798
- Cited by
- 45
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2019: 1 · 2018: 1 · 2015: 1 · 2014: 1 · 2012: 3
- FWCI
- 4.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Dementia and Geriatric Cognitive Disorders (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- 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 › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- Alzheimer's disease, Braak staging, neurofibrillary tangles, inter-rater reliability, intra-rater reliability, cerebral cortex, neuropathology, brain banking
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Brain, Female, Humans, Male, Middle Aged, Reproducibility of Results, Observer Variation, Neurofibrillary Tangles, Amyloid Neuropathies
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