title: Predicting conversion to Alzheimer disease using standardized clinical information.
abstract: OBJECTIVE
  To identify aspects of a standardized clinical assessment that can predict which individuals within the category of "questionable" Alzheimer disease (AD) have a high likelihood of converting to AD over time.
  
  
  METHODS
  Detailed semistructured interviews were performed at baseline and annually for 3 years.
  
  
  METHODS
  University-based gerontology research program.
  
  
  METHODS
  The patient population consisted of 165 individuals 65 years and older: 42 of the participants had a Clinical Dementia Rating (CDR) of normal cognition (CDR rating, 0.0) and 123 had a rating of questionable AD (CDR rating, 0.5). After 3 years of follow-up, 23 of the 123 subjects with questionable AD were diagnosed with probable AD.
  
  
  METHODS
  The interview was used to generate a summary measure based on the sum of 6 CDR categories, known as the Total Box Score. The responses to 32 selected questions from the interview also were examined.
  
  
  RESULTS
  Likelihood of progression to AD during the follow-up period was strongly related to the Total Box Score. For example, more than 50% of individuals with a Total Box Score of 2.0 or higher at baseline developed AD during the follow-up interval, whereas about 10% of individuals with a Total Box Score of 1.0 or lower developed AD during this same period. Selected questions from the standardized clinical interview also were highly predictive of subsequent conversion to AD among the study population. Eight selected questions from the clinical interview at baseline, combined with the CDR Total Box Score, identified 88.6% of such individuals accurately (questionable group, 82/91; converter group, 19/23).
  
  
  CONCLUSIONS
  A standardized clinical assessment can be used to identify the subgroup of individuals within the category of questionable AD who have a high likelihood of converting to AD over time. Subjects who met the criteria for questionable AD had a variety of trajectories during a 3-year follow-up, suggesting that diverse factors may influence the functional changes observed in this population.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
authors.forename: E
authors.initials: E
authors.lastname: Daly
authors.forename: D
authors.initials: D
authors.lastname: Zaitchik
authors.forename: M
authors.initials: M
authors.lastname: Copeland
authors.forename: J
authors.initials: J
authors.lastname: Schmahmann
authors.forename: J
authors.initials: J
authors.lastname: Gunther
authors.forename: M
authors.initials: M
authors.lastname: Albert
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D003072:Cognition Disorders / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015203:Reproducibility of Results