Neuropathologic diagnostic outcomes from a cohort of outpatients with suspected dementia

BACKGROUND: Researchers, clinicians, patients, and families need to know the accuracy of clinical dementia diagnoses. METHODS: A prospective cohort of outpatients presenting with complaints of cognitive impairment to a geriatric clinic was established from 1978 to 1982. All patients initially received a standardized clinical evaluation and then were followed longitudinally. RESULTS: Of 304 patients originally enrolled, 72 have come to autopsy and neuropathologic evaluation. Of those patients, 56 had been clinically diagnosed with Alzheimer's disease (AD) and 16 had been diagnosed with other conditions. The sensitivity, specificity, and diagnostic accuracy of the clinical diagnosis of AD compared with neuropathologic diagnosis was 95%, 81%, and 92%, respectively. CONCLUSION: Our findings support the conclusion that the practicing clinician using standardized clinical criteria can accurately diagnose AD approximately 90% of the time. These data may also be useful in the planning of future care of the AD patient.