The accuracy of short clinical rating scales in neuropathologically diagnosed dementia.
OBJECTIVE
The overall aim was to evaluate to what extent the diagnosis of dementia subtypes, obtained by three clinical rating scales, concurred with postmortem neuropathologic (NP) diagnosis of Alzheimer disease (AD), frontotemporal dementia (FTD), vascular dementia (VaD) and mixed AD/VaD.


METHODS
A prospective longitudinal clinical work-up with postmortem NP examination.


METHODS
Two hundred nine patients with dementia referred for clinical evaluation and follow-up.


METHODS
The diagnostic scores in a set of three short clinical rating scales for AD, FTD, and VaD were evaluated against NP diagnoses.


RESULTS
The sensitivity and specificity of the AD scale were 0.80 and 0.87, respectively, of the FTD scale 0.93 and 0.92, respectively, and of the Hachinski Ischemic Score (HIS, VaD diagnosis) 0.69 and 0.92, respectively. Cases with mixed AD/VaD generally presented a combination of high AD and ischemic scores. A preferred cutoff score of six was identified for both the AD and FTD scales.


CONCLUSIONS
All three clinical rating scales showed a high sensitivity and specificity, in close agreement with final NP diagnosis-for the HIS a moderate sensitivity. These scales may thus be considered good diagnostic tools and are recommended for clinical and research center settings.
Gustafson
Lars
L
Department of Geriatric Psychiatry, Clinical Sciences, Lund, Lund University, Sweden. Lars.Gustafson@med.lu.se
Englund
Elisabet
E
Brunnström
Hans
H
Brun
Arne
A
Erikson
Catarina
C
Warkentin
Siegbert
S
Passant
Ulla
U
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology; D001921:Brain / Q000098:blood supply / Q000473:pathology; D010054:Brief Psychiatric Rating Scale / Q000592:standards / Q000706:statistics & numerical data; D015140:Dementia, Vascular / Q000175:diagnosis / Q000453:epidemiology; D003933:Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology