TY - JOUR T1 - Operationalizing diagnostic criteria for Alzheimer's disease and other age-related cognitive impairment-Part 2. JF - Alzheimers Dement Y1 - 2011 A1 - Seshadri, Sudha A1 - Alexa S. Beiser A1 - Au, Rhoda A1 - Philip A Wolf A1 - Robert S Wilson A1 - Ronald C Petersen A1 - David S Knopman A1 - Walter A Rocca A1 - Claudia H Kawas A1 - Maria M Corrada A1 - Brenda L Plassman A1 - Kenneth M. Langa A1 - Helena C Chui KW - Age Factors KW - Aging KW - Alzheimer disease KW - Cognition Disorders KW - Community Health Planning KW - Humans KW - Incidence KW - Longitudinal Studies KW - Neuropsychological tests KW - Prevalence KW - United States AB -

This article focuses on the effects of operational differences in case ascertainment on estimates of prevalence and incidence of cognitive impairment and/or dementia of the Alzheimer type. Experience and insights are discussed by investigators from the Framingham Heart Study, the East Boston Senior Health Project, the Chicago Health and Aging Project, the Mayo Clinic Study of Aging, the Baltimore Longitudinal Study of Aging, and the Aging, Demographics, and Memory Study. There is a general consensus that the single most important factor determining prevalence estimates of Alzheimer's disease (AD) is the severity of cognitive impairment used as a threshold to define cases. Studies that require a level of cognitive impairment in which persons are unable to provide self-care will have much lower estimates than the studies aimed at identifying persons in the earliest stages of AD. There are limited autopsy data from the aforementioned epidemiological studies to address accuracy in the diagnosis of etiological subtype, namely the specification of AD alone or in combination with other types of pathology. However, other community-based cohort studies show that many persons with mild cognitive impairment and also some persons without dementia or mild cognitive impairment meet pathological criteria for AD, thereby suggesting that the number of persons who would benefit from an effective secondary prevention intervention is probably higher than the published prevalence estimates. Improved accuracy in the clinical diagnosis of AD is anticipated with the addition of molecular and structural biomarkers in the next generation of epidemiological studies.

PB - 7 VL - 7 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21255742?dopt=Abstract U2 - PMC3039838 U4 - Alzheimer disease/cognitive Impairment/PREVALENCE/Incidence/Dementia ER -