NINCDS-ADRDA_Criteria_for_Alzheimers_Disease v.1

NINCDS-ADRDA Criteria for Alzheimer’s Disease diagnoses Alzheimer's disease (AD), alternative to IWG-2 Criteria.

Therese Lindberg

therese.lindberg@cambio.se

@CambioCDS

To diagnose Alzheimer's disease (AD), alternative to IWG-2 Criteria.

Definite Alzheimer’s Disease: Histopathologic evidence obtained from a biopsy or autopsy plus all criteria for Probable Alzheimer’s Disease (1-6 below). Probable Alzheimer’s Disease* (must have all 6): 1. Dementia established by clinical examination and documented by the Mini-Mental Test, Blessed Dementia Scale, or some similar examination, and confirmed by neuropsychological tests. 2. Deficits in ≥2 areas of cognition. 3. Progressive worsening of memory and other cognitive functions. 4. No disturbance of consciousness. 5. Onset at age >40 to <90 years. 6. Absence of systemic disorders or other brain diseases that in and of themselves could account for the progressive deficits in memory and cognition. *Additionally, the diagnosis of Probable AD is supported by the following: 1. Progressive deterioration of specific cognitive functions such as language (aphasia), motor skills (apraxia), and perception (agnosia). 2. Impaired activities of daily living and altered patterns of behavior. 3. Family history of similar disorders, particularly if confirmed neuropathologically. 4. Lab results: - Normal lumbar puncture. - Normal pattern or nonspecific changes in EEG (e.g. increased slow-wave activity). - Cerebral atrophy on CT with progression documented by serial observation. Features that make Probable AD diagnosis uncertain or unlikely: 1. Sudden, apoplectic onset. 2. Focal neurologic findings (e.g. hemiparesis, sensory loss, visual field deficits, and incoordination early in the course of the illness). 3. Seizures or gait disturbances at onset or very early in the course of the illness. 4. If neither of the above is fulfilled, Possible Alzheimer’s Disease (must have all 3): 1. Dementia syndrome, in the absence of other neurologic, psychiatric, or systemic disorders sufficient to cause dementia, and presence of variations in onset, in presentation, or in clinical course. 2. Presence of a second systemic or brain disorder sufficient to produce dementia but is not considered to be the cause of dementia. 3. A single, gradually progressive severe cognitive deficit is identified in the absence of other identifiable cause. FACTS & FIGURES Interpretation: Clinical diagnosis for AD Rate of AD by pathological diagnosis Probable AD 91% Possible AD 92% The sensitivity and specificity of a clinical diagnosis of Probable AD or Possible AD for a pathological diagnosis of AD are 83% and 84%.

1. Mckhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984;34(7):939-44.

EVALUATION.nincds_adrda_criteria_for_alzheimers_disease.v0