The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease
Corresponding Author
Guy M. McKhann
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD, USA
Corresponding author: Tel.: 410-516-8640; Fax: 410-516-8648.
E-mail address: [email protected]
Search for more papers by this authorDavid S. Knopman
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorHoward Chertkow
Department of Neurology, McGill University School of Medicine, Montreal, QC, Canada
Bloomfield Centre for Research in Aging, Lady Davis Institute, Montreal, QC, Canada
Search for more papers by this authorBradley T. Hyman
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Search for more papers by this authorClifford R. Jack Jr.
Department of Radiology, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorClaudia H. Kawas
Department of Neurology, University of California, Irvine, CA, USA
Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
Alzheimer Disease Research Center, University of California, Irvine, CA, USA
Search for more papers by this authorWilliam E. Klunk
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Search for more papers by this authorWalter J. Koroshetz
National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
Search for more papers by this authorJennifer J. Manly
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
Department of Neurology, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorRichard Mayeux
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
Department of Neurology, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorJohn C. Morris
Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
Search for more papers by this authorMartin N. Rossor
Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, University College London, Queen Square, London, United Kingdom
Search for more papers by this authorPhilip Scheltens
Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorSandra Weintraub
Department of Psychiatry, Northwestern Feinberg School of Medicine, Chicago, IL, USA
Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, IL, USA
Search for more papers by this authorCreighton H. Phelps
Alzheimer's Disease Centers Program, National Institute on Aging, Bethesda, MD, USA
Search for more papers by this authorCorresponding Author
Guy M. McKhann
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD, USA
Corresponding author: Tel.: 410-516-8640; Fax: 410-516-8648.
E-mail address: [email protected]
Search for more papers by this authorDavid S. Knopman
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorHoward Chertkow
Department of Neurology, McGill University School of Medicine, Montreal, QC, Canada
Bloomfield Centre for Research in Aging, Lady Davis Institute, Montreal, QC, Canada
Search for more papers by this authorBradley T. Hyman
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Search for more papers by this authorClifford R. Jack Jr.
Department of Radiology, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorClaudia H. Kawas
Department of Neurology, University of California, Irvine, CA, USA
Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
Alzheimer Disease Research Center, University of California, Irvine, CA, USA
Search for more papers by this authorWilliam E. Klunk
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Search for more papers by this authorWalter J. Koroshetz
National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
Search for more papers by this authorJennifer J. Manly
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
Department of Neurology, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorRichard Mayeux
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
Department of Neurology, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorJohn C. Morris
Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
Search for more papers by this authorMartin N. Rossor
Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, University College London, Queen Square, London, United Kingdom
Search for more papers by this authorPhilip Scheltens
Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorSandra Weintraub
Department of Psychiatry, Northwestern Feinberg School of Medicine, Chicago, IL, USA
Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, IL, USA
Search for more papers by this authorCreighton H. Phelps
Alzheimer's Disease Centers Program, National Institute on Aging, Bethesda, MD, USA
Search for more papers by this authorAbstract
The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia.
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