Clinical Methods Rival Imaging for Alzheimer's Diagnosis

By Wachter, Kerri | Clinical Psychiatry News, November 2005 | Go to article overview

Clinical Methods Rival Imaging for Alzheimer's Diagnosis


Wachter, Kerri, Clinical Psychiatry News


WASHINGTON -- Clinical diagnosis of Alzheimer's disease may be just as accurate as neuroimaging, blood work, and interview of a knowledgeable informant, David A. Bennett, M.D., said at an international conference sponsored by the Alzheimer's Association.

Rates of pathologic confirmation of clinical AD, made without the benefit of such diagnostic tools, in the Religious Orders Study (ROS) and the Rush Memory and Aging Project (MAP) compared favorably with confirmation rates in a clinic-based setting that took advantage of as many diagnostic aids as necessary, said Dr. Bennett, director of the Alzheimer's Disease Center at Rush University Medical Center in Chicago.

The ROS is following more than 1,000 older religious clergy from across the United States, who have agreed to medical and psychological evaluation each year and brain donation after death for autopsy. The Rush MAP is following more than 1,000 residents of 40 retirement homes and senior housing facilities in the Chicago area, who also have agreed to medical and psychologic evaluation each year and donation of the brain, spinal cord, and selected nerves and muscles after death.

The two studies have been major undertakings, involving thousands of clinical evaluations. To reduce costs and provide uniformity of the evaluations, the researchers in both studies avoid using informants, neuroimaging, blood work or routine consensus conferencing. Instead, they rely on a system of guided clinical judgment developed for the studies. The system combines actuarial prediction rules with clinical judgment.

Each year the researchers evaluate each participant using complete neuropsychologic evaluations, involving about 20 tests--11 of which have age-adjusted cutoff scores.

A neuropsychologist reviews selected data from the test results to determine the subject's level of cognition. A clinician also reviews selected data, interviews and examines the patient, and makes a determination about cognitive decline, stroke, Parkinson's disease, depression, and other common conditions.

Selected data from these evaluations then are entered into a software actuarial decision tree to make a clinical diagnosis. The clinician has the opportunity to override the computer-generated decision. Clinicians and specialists are blinded to the previous years' results. When a participant dies, all the clinical data are reviewed by a neurologist, who makes a final clinical diagnosis.

Rates of the pathological confirmation of disease from the ROS and Rush MAP studies were compared with those from the Rush Alzheimer's Disease Center clinic, where over 600 Chicago-area patients, who have agreed to annual evaluations and brain donation upon death are treated.

"In the clinic, we follow the commonly accepted procedures, consistent with the current practice parameters--detailed neuropsychological testing, an interview with a knowledgeable informant, structural neuroimaging, blood work, and other ancillary tests that are clinically indicated," said Dr. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Clinical Methods Rival Imaging for Alzheimer's Diagnosis
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.