Clinical-Neuropathological Correlations in Alzheimer's Disease and Related Dementias

摘要: Objective: To compare neurologists' initial clinical diagnoses made according to National Institute of Neurological and Communicative Disorders Stroke-Alzheimer's Disease Related Association (NINCDS-ADRDA) Diagnostic Statistical Manual Mental Disorders, Revised Third Edition guidelines with neuropathological Alzheimer's disease (AD) related dementias. Design: Consecutive autopsies in a prospective cohort study. Setting: Community-dwelling patients dementia referred neurologists at an Research Center satellite clinics (n=151) initially evaluated when institutionalized (n=19). Patients: Of 204 elderly who had autopsy performed, 170 received complete evaluation NINCDS-ADRDA guidelines. Main Outcome Measures: Percentage agreement between pathological findings. Results: 137 clinically diagnosed as having probable or possible AD, 123 (90%) AD findings; this included 29 accompanied by Lewy bodies, 14 one more infarcts. Cases vascular mixed (AD infarct [s]) lower rates Possible cases were likely than show features other AD. Clinicians predicted the presence absence findings significantly better chance. In lesions, older age onset male gender associated shorter duration from death. Conclusions: accurately their most cases. Attributing degenerative dementias misdiagnosing combined bodies misjudging contribution major areas inaccuracy. Formal criteria for non-AD infarcts need be developed tested.