Cited by 189Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsPsychological Testing and Assessment

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Alzheimer’s disease can be accurately diagnosed in very mildly impaired individuals

Salmon, D. P., Thomas, R. G., Pay, M. M., Booth, A., Hofstetter, C. R., Thal, L. J., Katzman, R.·2002·Neurology

DOI 10.1212/wnl.59.7.1022

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Abstract

BACKGROUND: The growing propensity to diagnose AD in individuals with very mild cognitive impairment increases the danger of false-positive diagnostic errors. Unfortunately, there is little systematically acquired information about the accuracy of the AD diagnosis in very mildly impaired patients. OBJECTIVE: To determine the accuracy of the diagnosis of AD in very mildly impaired patients and to identify objective measures that effectively distinguish these patients from elderly normal controls (NC). METHODS: Consecutive patients with Mini-Mental State Examination scores of > or = 24 who received a clinical diagnosis of AD were evaluated annually for at least 3 years. The initial diagnosis was verified or refuted by autopsy or by information obtained in subsequent evaluations. Initial neuropsychological test scores of verified AD patients were compared with those of NC subjects to identify effective diagnostic measures. RESULTS: The diagnosis of AD was confirmed in 98 of 110 (89%) very mildly impaired patients (33/36 by autopsy, 65/74 by disease progression). The diagnosis was inaccurate in 12 patients (11%): Seven were subsequently diagnosed with other neurologic disorders, and five were ultimately found to be normal. Neuropsychological measures of delayed recall, verbal fluency, and global cognitive status (i.e., Mattis Dementia Rating Scale) provided excellent sensitivity (> or = 96%) and specificity (> or = 93%) for differentiating between very mildly impaired AD patients and NC subjects. CONCLUSIONS: When comprehensive assessment procedures are employed, AD can be diagnosed with reasonably high accuracy in very mildly impaired individuals. However, the dementia evaluation should be repeated after approximately 1 year to ensure the accuracy of the initial diagnosis.

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Authors: Salmon, D. P., Thomas, R. G., Pay, M. M., Booth, A., Hofstetter, C. R., Thal, L. J., & Katzman, R.
Affiliations: University of California San Diego (US)
ORCID: Salmon, D. P.
Thomas, R. G.
Booth, A.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2002-10-08
Volume: 59
Issue: 7
Pages: 1022-1028
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.59.7.1022
OpenAlex: W2051753984
Cited by: 189
References: 41
Citations by year: 2026: 2 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 7 · 2019: 6 · 2018: 3 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 8 · 2013: 12 · 2012: 11
FWCI: 7.15
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Funders: University of California, San Diego
National Institute on Aging (P50AG005131)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords: Alzheimer's disease, mild cognitive impairment, diagnostic accuracy, false-positive diagnosis, diagnostic errors, neuropsychological assessment, delayed recall, verbal fluency, Mattis Dementia Rating Scale, autopsy confirmation, disease progression, dementia assessment
MeSH terms: Aged, Aged, 80 and over, Alzheimer Disease, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Regression Analysis

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Alzheimer’s disease can be accurately diagnosed in very mildly impaired individuals

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