THE NATURAL-HISTORY OF ALZHEIMERS-DISEASE - DESCRIPTION OF STUDY COHORT AND ACCURACY OF DIAGNOSIS
THE NATURAL-HISTORY OF ALZHEIMERS-DISEASE - DESCRIPTION OF STUDY COHORT AND ACCURACY OF DIAGNOSIS
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DOI：
10.1001/archneur.1994.00540180063015
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发表时间：
1994-06-01
影响因子：
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通讯作者：
BRENNER, R
中科院分区：
文献类型：
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作者：
BECKER, JT;BOLLER, F;BRENNER, R
目的：我们描述的抽样，初步评估，并最终诊断分类的受试者参加了阿尔茨海默氏病（AD）的自然史研究设计：志愿者队列研究设置：多学科行为神经学研究clinic.Patients或其他参与者：319人参加了1983年3月和1988年3月之间的阿尔茨海默氏症研究计划。其中，204最初被归类为AD，102是正常的老年对照组，和13被认为是特殊cases.Main结果措施：最终共识临床诊断，最终神经病理诊断，和death.Results：在204例患者参加了这项研究，重新审查后，多达5年的后续行动导致最终的临床分类188可能AD。七名患者被认为有显着的血管成分的痴呆症，三人被发现有抑郁症，六人被排除在其他临床理由。50例脑神经病理检查显示43例为AD。在排除这7名误诊患者后，最后一组可能/确诊的AD患者共计181人。基线临床诊断相对于神经病理学的准确性为86%，考虑随访临床数据时为91.4%。详细的神经心理学测试产生了较高的敏感性（0.988）和特异性（0.983）痴呆。从进入研究到死亡的生存时间分析显示，老年患者在随访期间死亡的可能性明显更大，但性别、受教育年限和认知障碍模式均与生存无关。结论：这些数据为该队列的未来研究提供了描述性基础。他们指出，对痴呆病例的纵向随访增加了诊断的准确性，详细的认知测试有助于早期分类。
Objective: We describe the sampling, initial evaluation, and final diagnostic classification of subjects enrolled in a natural history study of Alzheimer's disease (AD).Design: Volunteer cohort study.Setting: Multidisciplinary behavioral neurology research clinic.Patients or Other Participants: Three-hundred nineteen individuals were enrolled in the Alzheimer Research Program between March 1983 and March 1988. Of these, 204 were originally classified with AD, 102 were normal elderly control subjects, and 13 were considered special cases.Main Outcome Measures: Final consensus clinical diagnosis, final neuropathologic diagnosis, and death.Results: Of the 204 patients enrolled in the study, re-review after as many as 5 years of follow-up resulted in a final clinical classification of 188 with probable AD. Seven patients were believed to have a significant vascular component to the dementia, three were found to have developed depression, and six were excluded on other clinical grounds. Neuropathologic examination of 50 brains indicated definite AD in 43. After removing these seven misdiagnosed patients, the final group of probable/definite AD totaled 181 individuals. Accuracy of the baseline clinical diagnosis relative to neuropathology was 86%, and when follow-up clinical data were considered, 91.4%. Detailed neuropsychological testing yielded high sensitivity (0.988) and specificity (0.983) to dementia. Analyses of survival time from study entry until death revealed that older patients were significantly more likely to die during follow-up, but neither sex, years of education, nor pattern of cognitive impairment were related to survival.Conclusions: These data provide the descriptive basis for future studies of this cohort. They indicate that longitudinal follow-up of demented cases increases accuracy of diagnosis, and that detailed cognitive testing aids in early classification.