Concordance of clinical alzheimer diagnosis and neuropathological features at autopsy

Kathryn Gauthreaux; Tyler A. Bonnett; Lilah M. Besser; Willa D. Brenowitz; Merilee Teylan; Charles Mock; Yen Chi Chen; Kwun C.G. Chan; C. Dirk Keene; Xiao Hua Zhou; Walter A. Kukull

doi:10.1093/jnen/nlaa014

Concordance of clinical alzheimer diagnosis and neuropathological features at autopsy

Kathryn Gauthreaux, Tyler A. Bonnett, Lilah M. Besser, Willa D. Brenowitz, Merilee Teylan, Charles Mock, Yen Chi Chen, Kwun C.G. Chan, C. Dirk Keene, Xiao Hua Zhou, Walter A. Kukull

Department of Neurology

Research output: Contribution to journal › Article › peer-review

34 Scopus citations

Abstract

It remains unclear what clinical features inform the accuracy of a clinical diagnosis of Alzheimer disease (AD). Data were obtained from the National Alzheimer's Coordinating Center to compare clinical and neuropathologic features among participants who did or did not have Alzheimer disease neuropathologic changes (ADNC) at autopsy. Participants (1854) had a clinical Alzheimer dementia diagnosis and ADNC at autopsy (Confirmed-AD), 204 participants had an AD diagnosis and no ADNC (AD-Mimics), and 253 participants had no AD diagnosis and ADNC (Unidentified-AD). Compared to Confirmed-AD participants, AD-Mimics had less severe cognitive impairment, while Unidentified-AD participants displayed more parkinsonian signs, depression, and behavioral problems. This study highlights the importance of developing a complete panel of biomarkers as a tool to inform clinical diagnoses, as clinical phenotypes that are typically associated with diseases other than AD may result in inaccurate diagnoses.

Original language	English
Pages (from-to)	465-473
Number of pages	9
Journal	Journal of neuropathology and experimental neurology
Volume	79
Issue number	5
DOIs	https://doi.org/10.1093/jnen/nlaa014
State	Published - May 1 2020

Keywords

Alzheimer disease
Diagnosis
Neuropathology

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10.1093/jnen/nlaa014

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title = "Concordance of clinical alzheimer diagnosis and neuropathological features at autopsy",

abstract = "It remains unclear what clinical features inform the accuracy of a clinical diagnosis of Alzheimer disease (AD). Data were obtained from the National Alzheimer's Coordinating Center to compare clinical and neuropathologic features among participants who did or did not have Alzheimer disease neuropathologic changes (ADNC) at autopsy. Participants (1854) had a clinical Alzheimer dementia diagnosis and ADNC at autopsy (Confirmed-AD), 204 participants had an AD diagnosis and no ADNC (AD-Mimics), and 253 participants had no AD diagnosis and ADNC (Unidentified-AD). Compared to Confirmed-AD participants, AD-Mimics had less severe cognitive impairment, while Unidentified-AD participants displayed more parkinsonian signs, depression, and behavioral problems. This study highlights the importance of developing a complete panel of biomarkers as a tool to inform clinical diagnoses, as clinical phenotypes that are typically associated with diseases other than AD may result in inaccurate diagnoses.",

keywords = "Alzheimer disease, Diagnosis, Neuropathology",

author = "Kathryn Gauthreaux and Bonnett, \{Tyler A.\} and Besser, \{Lilah M.\} and Brenowitz, \{Willa D.\} and Merilee Teylan and Charles Mock and Chen, \{Yen Chi\} and Chan, \{Kwun C.G.\} and \{Dirk Keene\}, C. and Zhou, \{Xiao Hua\} and Kukull, \{Walter A.\}",

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doi = "10.1093/jnen/nlaa014",

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pages = "465--473",

journal = "Journal of neuropathology and experimental neurology",

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T1 - Concordance of clinical alzheimer diagnosis and neuropathological features at autopsy

AU - Gauthreaux, Kathryn

AU - Bonnett, Tyler A.

AU - Besser, Lilah M.

AU - Brenowitz, Willa D.

AU - Teylan, Merilee

AU - Mock, Charles

AU - Chen, Yen Chi

AU - Chan, Kwun C.G.

AU - Dirk Keene, C.

AU - Zhou, Xiao Hua

AU - Kukull, Walter A.

PY - 2020/5/1

Y1 - 2020/5/1

N2 - It remains unclear what clinical features inform the accuracy of a clinical diagnosis of Alzheimer disease (AD). Data were obtained from the National Alzheimer's Coordinating Center to compare clinical and neuropathologic features among participants who did or did not have Alzheimer disease neuropathologic changes (ADNC) at autopsy. Participants (1854) had a clinical Alzheimer dementia diagnosis and ADNC at autopsy (Confirmed-AD), 204 participants had an AD diagnosis and no ADNC (AD-Mimics), and 253 participants had no AD diagnosis and ADNC (Unidentified-AD). Compared to Confirmed-AD participants, AD-Mimics had less severe cognitive impairment, while Unidentified-AD participants displayed more parkinsonian signs, depression, and behavioral problems. This study highlights the importance of developing a complete panel of biomarkers as a tool to inform clinical diagnoses, as clinical phenotypes that are typically associated with diseases other than AD may result in inaccurate diagnoses.

AB - It remains unclear what clinical features inform the accuracy of a clinical diagnosis of Alzheimer disease (AD). Data were obtained from the National Alzheimer's Coordinating Center to compare clinical and neuropathologic features among participants who did or did not have Alzheimer disease neuropathologic changes (ADNC) at autopsy. Participants (1854) had a clinical Alzheimer dementia diagnosis and ADNC at autopsy (Confirmed-AD), 204 participants had an AD diagnosis and no ADNC (AD-Mimics), and 253 participants had no AD diagnosis and ADNC (Unidentified-AD). Compared to Confirmed-AD participants, AD-Mimics had less severe cognitive impairment, while Unidentified-AD participants displayed more parkinsonian signs, depression, and behavioral problems. This study highlights the importance of developing a complete panel of biomarkers as a tool to inform clinical diagnoses, as clinical phenotypes that are typically associated with diseases other than AD may result in inaccurate diagnoses.

KW - Alzheimer disease

KW - Diagnosis

KW - Neuropathology

UR - https://www.scopus.com/pages/publications/85085313804

U2 - 10.1093/jnen/nlaa014

DO - 10.1093/jnen/nlaa014

M3 - Article

C2 - 32186726

AN - SCOPUS:85085313804

SN - 0022-3069

VL - 79

SP - 465

EP - 473

JO - Journal of neuropathology and experimental neurology

JF - Journal of neuropathology and experimental neurology

IS - 5

ER -

Concordance of clinical alzheimer diagnosis and neuropathological features at autopsy

Abstract

Keywords

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