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Assessment of Suspected Dementia

Published online by Cambridge University Press:  02 December 2014

H. Chertkow ,
H. Bergman ,
H.M. Schipper ,
A.M. Clarfield ,
S. Gauthier ,
S. Fontaine  and
R. Bouchard
H. Chertkow
Affiliation:
Bloomfield Centre for Research in Aging, Lady Davis Institute, Dept. of Clinical Neuroscience, and Dept. of Medicine, SMBD-Jewish General Hospital, McGill University, Division of Geriatric Medicine, Dept. of Medicine, McGill University Division of Geriatric Medicine, Dept. of Medicine, SMBD-Jewish General Hospital Research Centre, Institut Universitaire de Gériatrie de Montréal McGill Centre for Studies in Aging, McGill University
H. Bergman
Affiliation:
Bloomfield Centre for Research in Aging, Lady Davis Institute, Dept. of Clinical Neuroscience, and Dept. of Medicine, SMBD-Jewish General Hospital, McGill University, Division of Geriatric Medicine, Dept. of Medicine, McGill University Division of Geriatric Medicine, Dept. of Medicine, SMBD-Jewish General Hospital
H.M. Schipper
Affiliation:
Bloomfield Centre for Research in Aging, Lady Davis Institute, Dept. of Clinical Neuroscience, and Dept. of Medicine, SMBD-Jewish General Hospital, McGill University, Division of Geriatric Medicine, Dept. of Medicine, McGill University Division of Geriatric Medicine, Dept. of Medicine, SMBD-Jewish General Hospital
A.M. Clarfield
Affiliation:
Montreal, QC Canada, and Sarah Herzog Hospital, Jerusalem, Israel
S. Gauthier
Affiliation:
McGill Centre for Studies in Aging, McGill University
S. Fontaine
Affiliation:
Dept. of Radiology, Neurology, and Neurosurgery, Montreal Neurological Hospital, McGill University
R. Bouchard
Affiliation:
Professeur agrègè de clinique (neurologie), Université Laval
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Abstract

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At the Second Canadian Consensus Conference on Dementia (CCCD) (February, 1998), a group of neurologists, geriatricians, and psychiatrists met to consider guidelines for evaluation of dementia in Canada. This review paper formed a background paper for their discussion of dementia diagnosis. These experts from across the country concluded that diagnosis of suspected dementia cases continued to rest on skilled clinical assessment. Mental status exam, preferably in some quantifiable form, has become an essential part of the assessment. Selected laboratory tests are advisable in all cases (CBC, TSH, electrolytes, calcium, and glucose), but the CCCD continued to advise that CT scanning was mandatory only in selected cases where clinical findings pointed to another possibility besides Alzheimer’s disease. The growing list of other diagnostic measures with potential usefulness in diagnosis of Alzheimer’s disease or dementia in general was reviewed, but the evidence was judged as insufficient to support routine use of these tests by physicians. As new treatments for Alzheimer’s disease become available, neurologists face new diagnostic challenges - differentiating Mild Cognitive Impairment, Frontotemporal dementias and Mixed dementias, and Lewy Body Dementia. Guidelines to aid in differential diagnosis are presented.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 28 , Supplement S1: Canadian Consensus Conference on Dementia , May 2001 , pp. S28 - S41
Copyright
Copyright © The Canadian Journal of Neurological 2001

References

REFERENCES

Reisberg, B, Ferris, S. Diagnosis and assessment of the older patient Hosp Community Psychiatry 1982; 33 (2): 104–110.Google ScholarPubMed
Blackford, RC, LaRue, A. Criteria for diagnosing age-associated memory impairment: proposed revisions from the field Dev Neuropsychol 1989; 5: 295–306.CrossRefGoogle Scholar
Dawe, B, Procter, A. Concepts of mild memory impairment in the elderly and their relationship to dementia — a review Int J Geriatr Psychiatry 1992; 7: 473–479.CrossRefGoogle Scholar
Salthouse, TA. Adult Cognition: An Experimental Psychology of Human Aging. New York: Springer Verlag, 1982.Google Scholar
Garcia, C, Reding, M, Blass, J. Overdiagnosis of dementia J Am Geriatr Soc 1981; 29: 407–410.CrossRefGoogle ScholarPubMed
Ebly, EM, Hogan, DB, Parhad, IM. Cognitive impairment in the nondemented elderly Results from the Canadian Study of Health and Aging. Arch Neurol 1995; 52 (6): 612–619.Google ScholarPubMed
Kral, VA. Senescent forgetfulness: benign and malignant. Can Med Assoc J 1962; 86: 257–260.Google ScholarPubMed
Crook, T, Bartus, RT, Ferris, SH, et al. Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change: Report of a National Institute of Mental Helath Work Group Dev Neuropsychol 1986; 2: 261–276.CrossRefGoogle Scholar
Hughes, C, et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140: 566–572.CrossRefGoogle ScholarPubMed
Berg, L. Clinical dementia rating (CDR). Psychopharmacol Bull 1988; 24 (4): 637–639.Google ScholarPubMed
Levy, R. Report of the working party of the International Psychogeriatric Association in collaboration with the World Health Organization: aging–associated cognitive decline [published erratum appears in Int Psychogeriatr 1994;6(2):133]. Int Psychogeriatr, 1994; 6 (1): 63–68.Google Scholar
Petersen, RC, Smith, GE, Tangalos, EG, Kokmen, E, Ivnik, RJ. Longitudinal outcome of patients with a mild cognitive impairment Ann Neurol 1993; 34: 294–295.Google Scholar
Ritchie, K, et al. A typology of sub-clinical senescent cognitive disorder. Br J Psychiatry 1996; 168 (4): 470–476.CrossRefGoogle ScholarPubMed
Zaudig, M. Anew systematic method of measurement and diagnosis of mild cognitive impairment and dementia according to ICD-10 and DSM-III-R criteria. Int Psychogeriatr 1992; 4 (Suppl.2): 203–219.CrossRefGoogle Scholar
Petersen, RC, et al. Mild cognitive impairment: clinical characterization and outcome [published erratum appears in Arch Neurol 1999;56(6):760]. Arch Neurol 1999; 56 (3): 303–308.CrossRefGoogle Scholar
Daly, E, et al. Predicting conversion to Alzheimer’s disease using standardized clinical information. Arch Neurol 2000; 57 (5): 675–680.CrossRefGoogle ScholarPubMed
O’Connor, DW. Mild dementia: a clinical perspective. In: Hippert FA, Brayne C, O’Connor DW, eds. Dementia and Normal Aging. Cambridge University Press Cambridge. 1994; 91–118.Google Scholar
Chertkow, H. Mild memory loss in the elderly: can we predict development in dementia? Can J Neurol Sci 1998; 25 (1): S1–S4.Google Scholar
Hanninen, T, et al. A follow-up study of age-associated memory impairment: neuropsychological predictors of dementia. JAGS 1995; 43 (9): 1007–1015.CrossRefGoogle ScholarPubMed
Hogan, DB, Ebly, EM. Predicting who will develop dementia in a cohort of Canadian seniors. Can J Neurol Sci 2000; 27: 18–24.CrossRefGoogle Scholar
Morris, J. Healthy brain aging in nonagenarians and centenarians. Neurobiol Aging 2000; 21 (1S): S280.CrossRefGoogle Scholar
Ritchie, K, Touchon, J. Mild cognitive impairment: conceptual basis and current nosological status [see comments]. Lancet 2000; 355 (9199): 225–258.CrossRefGoogle ScholarPubMed
Morris, JC, et al. Very mild Alzheimer’s disease: informant-based clinical, psychometric, and pathologic distinction from normal aging. Neurology 1991; 41 (4): 469–478.CrossRefGoogle ScholarPubMed
Tierney, MC, et al. The prediction of Alzheimer’s disease. The role of patient and informant perceptions of cognitive deficits. Arch Neurol 1996; 53 (5): 423–427.CrossRefGoogle ScholarPubMed
McGlone, J, et al. Screening for early dementia using memory complaints from patients and relatives. Arch Neurol 1990; 47 (11): 1189–1193.CrossRefGoogle ScholarPubMed
Jorm, A, et al. Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample. Psychol Med 1997; 27 (1): 91–98.CrossRefGoogle ScholarPubMed
Schofield, PW, et al. The validity of new memory complaints in the elderly. Arch Neurol 1997; 54 (6): 756–759.CrossRefGoogle ScholarPubMed
Chertkow, HM, et al. Standard neuropsychological tests do not predict development of Alzheimer’s disease in indivduals with “Age-associated Cognitive Decline”. Can J Neurol Sci 1998; 25 (Suppl2): S27 (Abstract).Google Scholar
Fellows, L, Chertkow, H Bergman, H. Can clinical data predict progression to Alzheimer’s disease in patients with mild memory impairment?. Can J Neurol Sci 1998; 25 (Suppl2): S28 (Abstract).Google Scholar
Verret, L, et al. Disorientation to time as a predictor of progression to Alzheimer’s disease for age-associated cognitive decline patients. Can J Neurol Sci 1999; 26 (Suppl1): S16.Google Scholar
(CSHA). Canadian Study of Health and Aging: Risk factors for Alzheimer’s disease in Canada. Neurology 1994; 44 2073–2080.CrossRefGoogle Scholar
Graham, JE, et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997; 349 (9068): 1793–1796.CrossRefGoogle Scholar
(APA). A PA, Diagnostic and Statistical Manual of Mental Disorders, 4th ed.: DSM-IV. 4th ed. Washington, DC. 1994.Google Scholar
Gélinas, I. Disability assessment in dementia of the Alzheimer’s type. In: School of Physical and Occupational Therapy. McGill University: Montreal. 1995.Google Scholar
Gauthier, L. Gelinas I. Development of a functional measure for persons with Alzhaeimer’s disease: the disability assessment for dementia. Am J Occup Ther 1999; 53 471–481.Google Scholar
Reisberg, B. Functional assessment staging (FAST). Psychopharmacol Bull 1988; 24 653–659.Google ScholarPubMed
Rosenman, S. The validity of the diagnosis of mild dementia. Psychol Med 1991; 21 (4):923–934.CrossRefGoogle ScholarPubMed
Erkinjuntti, T, The effect of different diagnostic criteria on the prevalence of dementia. New Eng J Med 1997; 337 (23):1667–1674.CrossRefGoogle ScholarPubMed
Wells, C. Chronic brain disease: an overview. Am J Psychiatry 1998; 135 1–12.Google Scholar
Clarfield, AM. The reversible dementias: do they reverse? Ann Int Med 1988; 109 (6):476–486.CrossRefGoogle ScholarPubMed
Clarfield, AM, Foley, JM. The American and Canadian consensus conferences on dementia: is there consensus? [see comments]. J Am Geriatr Soc 1993; 41 (8):883–886.CrossRefGoogle ScholarPubMed
Skoog, I, et al. A population-based study of dementia in 85-yearolds [see comments]. New Eng J Med 1993; 328 (3):153–158.CrossRefGoogle Scholar
Evans, DA, Funkenstein, H, Albert, MS, et al. Prevalence of Alzheimer’s disease in a community population of older persons. JAMA 1989; 262 (18):2551–2556.CrossRefGoogle Scholar
Weytingh, MD, Bossuyt, PM, van Crevel, H. Reversible dementia: more than 10% or less than 1%? A quantitative review. J Neurology 1995; 242: 466–471.CrossRefGoogle ScholarPubMed
Walstra, GJ, Teunisse, S, van Gool, W van Crevel, H. Reversible dementia in elderly patients referred to a memory clinic. J Neurology 1997; 244: 17–22.CrossRefGoogle ScholarPubMed
Geldmacher, D, Whitehouse, P. Evaluation of dementia. New Eng J Med 1996; 335 (5): 330–336.CrossRefGoogle ScholarPubMed
Geldmacher, DS, Whitehouse, PJ Jr. Differential diagnosis of Alzheimer’s disease. Neurology 1997; 48 (5 Suppl6): S2–S9.CrossRefGoogle ScholarPubMed
Kaye, JA Diagnostic challenges in dementia. Neurology 1998; 51 (Suppl1): S45–S52.CrossRefGoogle ScholarPubMed
Royall, DR, Polk, M. Dementias that present with and without posterior cortical features: an important clinical distinction. J Am Geriatr Soc 1998; 46 (1): 98–105.CrossRefGoogle ScholarPubMed
(CSHA) C.S.o.H.a.A. Canadian Study of Health and Aging Working Group: study methods and prevalence of dementia. Can Med Assoc J 1994; 150: 899–913.Google Scholar
McKhann, G, et al. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDAwork group under the auspices of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 939–944.CrossRefGoogle ScholarPubMed
Black, SE. Focal cortical atrophy syndromes. Brain Cogn 1996 31 (2): 188– 229.CrossRefGoogle ScholarPubMed
Neary, D, et al. Neuropsychological syndromes in presenile dementia due to cerebral atrophy. J Neurol Neurosurg Psychiatry 1986 49 163– 174.CrossRefGoogle ScholarPubMed
Neary, D. Non Alzheimer’s disease forms of cerebral atrophy [editorial]. J Neurol Neurosurg Psychiatry 1990 53 (11) 929–931.CrossRefGoogle ScholarPubMed
Gibb, WR. et al. Cortical Lewy body dementia: clinical features and classification. J Neurol Neurosurg Psychiatry 1989 52 (2) 185–192.CrossRefGoogle ScholarPubMed
Snowdon, J, Griffiths, H, Neary, D. Progressive language disorder associated with frontal lobe degeneration. Neurocase 1996 2 429–440.CrossRefGoogle Scholar
Kertesz, A, Davidson, W, Fox, H. Frontal behavioral inventory:diagnostic criteria for frontal lobe dementia. Can J Neurol Sci 1997 24 (1) 29–36.CrossRefGoogle ScholarPubMed
Neary, D, et al Frontotemporal lobal degeneration. A concensus on clinical diagnostic criteria Neurology 1998 51 (6) 1546–1554.Google Scholar
Chow, TW, et al Inheritance of frontotemporal dementia. Arch Neurol 1999 56 (7) 817–822.CrossRefGoogle ScholarPubMed
Perry, RJ, Hodges, JR. Differentiating frontal and temporal variant frontotemporal dementia from Alzheimer's disease. Neurology 2000; 54 (12) 2277–2284.CrossRefGoogle ScholarPubMed
Rahman, S, et al Specific cognitive deficits in mild frontal variant frontotemporal dementia. Brain 1999; 122 (8) 1469–1493.CrossRefGoogle ScholarPubMed
Miller, BL, et al Frontal lobe degeneration: clinical, neuropsychological, and SPECT characteristics. Neurology 1991; 41 (9) 1374–1382.CrossRefGoogle ScholarPubMed
Al-Asmi, A, Chertkow, H, Albrecht, S, et al Amyotrophic lateral sclerosis presenting as restricted cognitive impairment. In:American Neuropsychiatric Association meeting Honolulu, USA. 1998; Google Scholar
Marsden, CD., Neurological causes of dementia other than Alzheimer’s disease. In: Burrows K, ed. Handbook of Studies on Psychiatry and Old Age Elsevier Science Publishers B.V.. 1984; 145– 167.Google Scholar
Cummings, JL, Victoroff, JI. Noncognitive neuropsychiatric syndromes in Alzheimer’s disease. Neuropsychiatry Neuropsychol Behav Neurol 1990; 3 (2) 140– 158.Google Scholar
Chui, HC, et al. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology 1992; 42: 473– 480.CrossRefGoogle ScholarPubMed
Rockwood, K, et al. Diagnosis of vascular dementia: Consortium of Canadian Centres for Clinical Cognitive Research Consensus Statement. Can J Neurol Sci 1994; 21: 358– 364.CrossRefGoogle Scholar
Roman, GC, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop Neurology 1993; 43: (2): 250– 260.Google ScholarPubMed
Amar, K, et al. The presence of leuko-araiosis in patients with Alzheimer’s disease predicts poor tolerance to tacrine, but does not discriminate responders from non-responders. Age Ageing Neurology 1997; 26: (1): 25– 29.CrossRefGoogle Scholar
Gold, M. et al. Physostigmine and Alzheimer's disease [letter; comment]. Neurology 1997; 49: (2): 642– 643.CrossRefGoogle ScholarPubMed
Corey-Bloom, J, et al. Clinical features distinguishing large cohorts with possible AD, probable AD, and mixed dementia. J Am Geriatr Soc 1993; 41: (1): 31– 37.CrossRefGoogle ScholarPubMed
Hachinski, VC, Iliff, LD, Zilhka, E et al. Cerebral blood flow in dementia. Arch Neurol 1975; 32: 632– 637.CrossRefGoogle ScholarPubMed
Rosen, WG, Terry, RD, Fuld, PA, Katzman, R, Peck, A. Pathological verification of ischemic score in differentiation of dementia. Ann Neurol 1980; 7: 486– 488.CrossRefGoogle Scholar
Boller, F, Lopez, OL, Moossy, J., Diagnosis of dementia:clinicopathologic correlations. Neurology 1989; 39 (1): 76– 79.CrossRefGoogle ScholarPubMed
Snowdon, DA, et al. Brain infarction and the clinical expression of Alzheimer’s disease: the nun study. JAMA 1997; 277 (10): 813– 817.CrossRefGoogle ScholarPubMed
Forette, F, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial [see comments]. Lancet 1998; 352 (9137): 1347– 1351.CrossRefGoogle ScholarPubMed
Mayeux, R, Stern, Y, Spanton, S., Heterogeneity in dementia of the Alzheimer’s type: evidence of subgroups. Neurology 1985; 35 (4): 453– 461.CrossRefGoogle ScholarPubMed
Mayeux, R, Stern, Y., Spanton, S., Intellectual dysfunction and dementia in Parkinson 's disease. In: Mayeux R, Rosen WG. eds. The Dementias Raven Press: New York.1983; 211– 227.Google Scholar
McKeith, IG, et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB):report of the consortium on DLB international workshop. Neurology 1996; 47 (5): 1113– 1124.CrossRefGoogle Scholar
Gomez-Tortosa, E, et al. Clinical and quantitative pathologic correlates of dementia with Lewy bodies. Neurology 1999; 53 (6): 1284– 1291.CrossRefGoogle ScholarPubMed
Verghese, J, et al. Validity of clinical criteria for the diagnosis of dementia with Lewy bodies. Neurology 1999; 53 (9): 1974– 1982.CrossRefGoogle ScholarPubMed
McKeith, IG, Perry, EK, Perry, RH., Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Neurology 1999; 53 (5): 902– 905.CrossRefGoogle ScholarPubMed
Lopez, OL, et al. Accuracy of four clinical diagnostic criteria for the diagnosis of neurodegenerative dementias. Neurology 1999; 53 (6): 1292– 1299.CrossRefGoogle ScholarPubMed
Litvan, I, et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996; 47 (1): 1– 9.CrossRefGoogle ScholarPubMed
Pillon, B, et al. Heterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson’s disease, and Alzheimer’s disease. Neurology 1986; 36 (9): 1179– 1185.CrossRefGoogle ScholarPubMed
Johnson, RT, Gibbs, CJ Jr. et al. Creutzfeldt-Jakob disease and related transmissible spongiform encephalopathies. New Eng J Med 1998; 339 (27): 1994– 2004.CrossRefGoogle ScholarPubMed
Kretzschmar, HA, et al. Diagnostic criteria for sporadic Creutzfeldt-Jakob disease. Arch Neurol 1996; 53 (9): 913– 920.CrossRefGoogle ScholarPubMed
Zerr, I., et al. Detection of 14-3-3 protein in the cerebrospinal fluid supports the diagnosis of Creutzfeldt-Jakob disease. Ann Neurol 1998; 43 (1): 32– 40.CrossRefGoogle ScholarPubMed
Schneider, JA, et al. Corticobasal degeneration: neuropathologic and clinical heterogeneity. Neurology 1997; 48 (4): 959– 969.CrossRefGoogle ScholarPubMed
Kertesz, A, et al. The pathology and nosology of primary progressive aphasia [see comments]. Neurology 1994; 44 (11): 2065– 2072.CrossRefGoogle ScholarPubMed
Grimes, DA, Lang, AE, Bergeron, CB Dementia as the most common presentation of cortical-basal ganglionic degeneration. Neurology 1999; 53 (9): 1969– 1974.CrossRefGoogle ScholarPubMed
Caine, ED, Neuropsychology of depression: the pseudodementia syndrome. In: Grant I, Adams KM. eds. Neuropsychological Assessment of Neuropsychiatric Disorders Oxford University Press New York, 1986. Google Scholar
McAllister, TW, Price TRP. Severe depressive pseudodementia with and without dementia. Am J Psychiatry 1982; 139: 626–628.Google Scholar
Reifler, B, Larson, E, Hanley, R. Coexistence of dementia and depression in geriatric outpatients. Am J Psychiatry 1982; 139: 623–625.Google ScholarPubMed
Erkinjuntti, T, et al. Accuracy of the clinical diagnosis of vascular dementia: a prospective clinical and postmortem neuropathological study. J Neurol Neurosurg Psychiatry 1988; 51: 1037–1044.CrossRefGoogle ScholarPubMed
Erickson, R, Howieson, D. et al. The clinician’s perspective: measuring change and treatment effectiveness. In: L. Poon, ed. Clinical Memory Assessment of Older Adults American Psychological Association: Washington, DC. 1986; 69–80.Google Scholar
Appell, J, Kertesz, A, Fisman, M. A study of language functioning in Alzheimer’s patients. Brain Lang 1982; 17: 73–91.CrossRefGoogle Scholar
Lippa, CF, Johnson, R, Smith, TW. The medial temporal lobe in dementia with Lewy bodies: a comparative study with Alzheimer’s disease. Ann Neurol 1998; 43: (1) 102–106.CrossRefGoogle ScholarPubMed
McCartney, JR., Physician’s assessment of cognitive capacity:failure to meet the needs of the elderly. Arch Int Med 1986; 146: 177–178.CrossRefGoogle ScholarPubMed
Sluss, TK, Rabins, P, Gruenberg, EM, Reedman, G. Memory complaints in community residing men. Gerontologist 1980; 20 (20): 201–218.Google Scholar
Bolla-Wilson, K, Bleeker, M., Memory complaints – dementia or depression?. Gerontologist 1986; 26:142–149.Google Scholar
Rubin, EH, et al. Very mild senile dementia of the Alzheimer’s type. I. Clinical assessment. Arch Neurol 1989; 46(4): 379–382.Google Scholar
Fitz, AG, Teri, L. Depression, cognition, and functional ability in patients with Alzheimer’s disease. J Am Geriatr Soc 1994; 42(2):186–191.CrossRefGoogle ScholarPubMed
Barberger-Gateau, P, et al. Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers. J Am Geriatr Soc 1992; 40(11): 1129–1134.CrossRefGoogle ScholarPubMed
Huff, FJ, et al. The neurologic examination in patients with probable Alzheimer’s disease. Arch Neurol 1987; 44: 929–933.CrossRefGoogle ScholarPubMed
Serby, M, et al. Olfactory identification deficits in relatives of Alzheimer’s disease patients. Biol Psychiatry 1996; 39(5): 375–377.CrossRefGoogle ScholarPubMed
Graves, AB, et al. Impaired olfaction as a marker for cognitive decline: interaction with apolipoprotein E epsilon4 status. Neurology 1999; 53(7): 1480–1487.CrossRefGoogle ScholarPubMed
Galasko, D, et al. Neurological findings in Alzheimer’s disease and normal aging. Arch Neurol 1990; 47(6): 625–627.CrossRefGoogle ScholarPubMed
Franssen, E, et al. Cognition-independent neurologic symptoms in normal aging and probable Alzheimer’s disease. Arch Neurol 1991; 48(2): 148–154.CrossRefGoogle ScholarPubMed
Jenkyn, L, Reeves, A, Warner, T et al. Neurological signs in senescence. Arch Neurol 1985; 42: 1154–1157.CrossRefGoogle ScholarPubMed
Huff, F, Growdon, J., Neurological abnormalities associated with severity of dementia in Alzheimer’s disease. Can J Neurol Sci 1986; 13(4Suppl): 403–405.CrossRefGoogle ScholarPubMed
Lopez, OL, et al. Extrapyramidal signs in patients with probable Alzheimer’s disease. Arch Neurol 1997; 54(8): 969–969.CrossRefGoogle Scholar
Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189–198.CrossRefGoogle Scholar
Siu, A. Screening for dementia and investigating its causes (review). Ann Int Med 1991; 115(2): 122–132.CrossRefGoogle Scholar
Tombaugh, TN, McIntyre, NJ. The Mini-Mental State Examination: a comprehensive review. J Am Geriatr Soc 1992; 40: 922–935.CrossRefGoogle ScholarPubMed
Dick, JPR, et al. Mini-Mental State Examination in neurological patients. J Neurology Neurosurg Psychiatry 1984; 47: 496–499.CrossRefGoogle ScholarPubMed
Clark, CM, et al. Variability in annual Mini-Mental State Examination score in patients with probable Alzheimer’s disease: A clinical perspective of data from the Consortium to Establish a Registry for Alzheimer’s Disease. Arch Neurol 1999; 56(7): 857–862.CrossRefGoogle ScholarPubMed
Grober, E, Buschke, HCHBS, Dresner, R. Screening for dementia by memory testing. Neurology 1988; 38(6): 900–903.CrossRefGoogle ScholarPubMed
Tuokko, H, et al. The Clock Test: a sensitive measure to differentiate normal elderly from those with Alzheimer’s disease. J Am Geriatr Soc 1992; 40(6): 579–584.CrossRefGoogle Scholar
Stahelin, HB, Monsch, AU, Spiegel, R. Early diagnosis of dementia via a two-step screening and diagnostic procedure. Int Psychogeriatr 1997; 9(Suppl1): 123–130.CrossRefGoogle Scholar
Solomon, PR, et al. A 7 minute neurocognitive screening battery highly sensitive to Alzheimer’s disease. Arch Neurol 1998; 55(3): 349–355.CrossRefGoogle ScholarPubMed
Huff, FJ, et al. Cognitive deficits and clinical diagnosis of Alzheimer’s disease. Neurology 1987; 37(7): 1119–1124.CrossRefGoogle ScholarPubMed
Chui, H, Zhang, Q. Evaluation of dementia: a systematic study of the usefulness of the American Academyof Neurology’s practice parameters. Neurology 1997; 49(4): 925–935.CrossRefGoogle Scholar
Stern, Y, et al. Diagnosis of dementia in a heterogeneous population. Arch Neurol 1992; 49(5): 453–460.CrossRefGoogle Scholar
Clarfield, M., Assessing dementia: the Canadian Consensus. Can Med Assoc J 1991; 144: 851–853.Google Scholar
Corey-Bloom, J., et al. Diagnosis and evaluation of dementia. Neurology 1995; 2: 211–218.CrossRefGoogle Scholar
Patterson, CJ, et al. Canadian Consensus Conference on Dementia: a physician’s guide to using the recommendations [seecomments]. Can Med Assoc J 1999; 160(12): 1738–1742.Google ScholarPubMed
Helkala, EL, et al. Different patterns of cognitive decline related to normal or deteriorating EEG in a 3-year follow-up study of patients with Alzheimer’s disease. Neurology 1991; 41(4): 528–532.CrossRefGoogle ScholarPubMed
Hammerstrom, DC, Zimmer, B. The role of lumbar puncture in the evaluation of dementia: the University of Pittsburgh study. J Am Geriatr Soc 1985; 33(4): 397–400.CrossRefGoogle ScholarPubMed
Hsich, G, et al. The 14-3-3 brain protein in cerebrospinal fluid as a marker for transmissible spongiform encephalopathies [see comments]. New Eng J Med 1996; 335(13): 924–930.CrossRefGoogle ScholarPubMed
(AAN)Quality Standards Subcommittee of the Americal Academy of Neurology. Practice parameter for diagnosis and evaluation of dementia (Summary statement). Neurology 1994; 44: 2203–2206.Google Scholar
Rossor, MN. Management of neurological disorders: dementia. Neurol Neurosurg Psychiatry 1994; 57: 1451–1456.CrossRefGoogle ScholarPubMed
Small, GW et al. Diagnosis and treatment of Alzheimer's disease and related disorders: consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer’s Association and the AmericanGeriatrics Society. JAMA 1997; 278(16): 1363–1371.CrossRefGoogle Scholar
Gordon, M, Freedman, M. Evaluating dementia: What price testing?. Can Med Assoc J 1990; 142(12): 1367–1370.Google ScholarPubMed
Gauthier, S. Costs of diagnostic procedures. In: Wimo A, Jonsson B, Karlsson G, Winblad B, eds. Health Economics of Dementia. Chichester: John Wileyand Sons 1998; 269–275.Google Scholar
Patterson, C, Gauthier, S, Bergman, H, et al. The recognition, assessment and management of dementingdisorders: conclusions from the Canadian Consensus Conference on Dementia. Can Med Assoc J. 1999; 160(suppl12): S1–S15.Google Scholar
Creasey, H et al. Quantitative computed tomography in dementia of the Alzheimer’s type. Neurology. 1986; 36(12): 1563–1568.Google Scholar
Freter, S, et al. Prevalence of potentially reversible dementias and actual reversibility in a memory clinic cohort. Can Med Assoc J. 1998; 159(6): 657–662.Google Scholar
Willmer, J, et al. The usefulness of CT scanning in diagnosing dementia of the Alzheimer’s type. Can J Neurol Sci. 1993; 20(3):210–216.CrossRefGoogle Scholar
de Leon, MJ, et al. The radiologic prediction of Alzheimer’s disease: the atrophic hippocampal formation. AJNR Am J Neuroradiol. 1993; 14(4):897–906.Google ScholarPubMed
Kidron, D, et al. Quantitative MR volumetry in Alzheimer’s disease. Topographic markersand the effects of sex and education. Neurology 1997; 49(6):1504–1512.Google ScholarPubMed
Jack, C, et al. Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment. Neurology. 1999; 52(7):1397–1403.CrossRefGoogle ScholarPubMed
Murtha, S, et al. Mild cognitive impairment and the neuroanatomical changes associated with assessment of progression to dementia. Neurobiol Aging. 2000; 21(Suppl1): S29.CrossRefGoogle Scholar
Steingart, A, et al. Thesignificance of white matter lucencies on CT scan in relation to cognitive impairment. Can J Neurol Sci. 1986; 13(4Suppl): 383–384.CrossRefGoogle Scholar
Steingart, A, et al. Cognitive and neurologic findings in demented patients with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol. 1987; 44(1): 36–39.CrossRefGoogle ScholarPubMed
Inzitari, D Age-related white matter changes and cognitive impairment [editorial; comment]. Ann Neurol. 2000; 47(2): 141–143.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Jagust, WJ, Budinger, TF, Reed, BR The diagnosis of dementia with single photon emission computed tomography. Arch Neurol. 1987; 44(3): 258–262.CrossRefGoogle ScholarPubMed
Johnson, KA, et al. Preclinical prediction of Alzheimer’s disease using SPECT. Neurology. 1998; 50: 1563–1571.CrossRefGoogle ScholarPubMed
Powers, WJ, et al. Blinded clinical evaluation of positron emission tomography for diagnosis of probable Alzheimer’s disease. Neurology. 1992; 42: 765–770.CrossRefGoogle ScholarPubMed
Bergman, H, et al. HM-PAO (CERETEC) SPECTbrain scanning in the diagnosis of Alzheimer’s disease. J Am Geriatr Soc. 1997; 45(1):15–20.CrossRefGoogle ScholarPubMed
Jagust, W, et al. Single-photon emission computed tomographic perfusion imaging in autopsy-diagnosed dementia. J Neuroimaging. 1993; 3: 93–99.CrossRefGoogle Scholar
Geaney, D, Abouh-saleh, M. The use and applications of singlephoton emission computerised in tomography dementia. Br J Psychiatry. 1990; 157(Suppl9): 66–75.CrossRefGoogle Scholar
Johnson, KA, Holman, L, Rosen, TJ Iofetamine, I 123 single photon emission computed tomography is accurate in the diagnosisof Alzheimer’s disease. Arch Int Med. 1990; 150: 752–756.CrossRefGoogle Scholar
Black, SE., Holman, L, Can SPECT predict the future for mild cognitive impairment?. Can J Neurol Sci. 1999; 26: 4–6.Google ScholarPubMed
Johnson, KA, Jones, K, Holman, BL, et al. Preclinical prediction of Alzheimer’s disease using SPECT. Neurology. 1998; 50: 1563–1571.CrossRefGoogle ScholarPubMed
McKelvey, R, et al. Lackof prognostic significance of SPECT abnormalities in non-demented elderly subjects with memoryloss. Can J Neurol Sci. 1999; 26: 23–28.Google Scholar
Kennard, M. Diagnostic markers for A lzheimer’s disease. Neurobiol Aging. 1998; 19(2): 131–132.CrossRefGoogle Scholar
Galasko, D. CSF tau and AB42: logical biomarkers for Alzheimer’s disease. Neurobiol Aging. 1998; 19(2): 117–119.CrossRefGoogle Scholar
Schipper, HM, Chertkow, H, Mehindate, K, et al. Evaluation of heme oxygenase-1 levels as a systemic biological marker of sporadic AD. Neurology. 2000; 54: 1297–1304.CrossRefGoogle ScholarPubMed
Mayeux, R, et al. Utility of the apolipoprotein E genotype in the diagnosis of Alzheimer’s disease. Alzheimer’s Disease Centers Consortium on Apolipoprotein E and Alzheimer’s Disease. New Eng J Med. 1998; 338(8): 506–511.CrossRefGoogle Scholar
Corder, EH, et al. Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late-onset families. Science. 1993; 261(5123): 921–923.CrossRefGoogle ScholarPubMed
Farlow, MR. Alzheimer’s disease: clinical implications of the apolipoprotein E genotype. Neurology. 1997; 48(Suppl6): S30–S34.CrossRefGoogle ScholarPubMed