HOME PAGE
CRITERIA FOR THE DIAGNOSIS OF PROBABLE ALZHEIMERS
DISEASE
(National Institute of Neurological and Communicative Diseases and Stroke
and distributed by the Long Island Alzheimers Foundation, 516 869-9627)
1. Criteria for clinical diagnosis of probable Alzheimers disease include:
-
Dementia established by clinical examination and documented by Mini Mental
(Folstein, Folstein, McHugh, 1975) Blessed Dementia Scale (Blessed, Tomlinson,
Roth, 1968), or some other similar examination and confirmed by a
neuropsychological tests
-
Deficits into more areas of cognition, progressive worsening of memory and
other cognitive functions
-
No disturbance of consciousness
-
Onset between ages 40 in 90, most often after age 65
-
Absence of systemic disorders or other brain diseases that in a themselves
could account for progressive deficits in memory and cognition
2. Diagnosis of probable Alzheimers disease is supported by:
-
Progressive deterioration of specific cognitive functions, such as a language
(Aphasia), motor skills (apraxia) and perception (agnosia)
-
Impaired activities of daily living and altered patterns of behavior
-
Family history of similar disorders, particularly if confirmed
neuropathologically
-
Laboratory results of normal lumbar puncture as evaluated by standard techniques,
normal pattern or nonspecific changes in EEG, such as increased slow-wave
activity, and evidence of cerebral atrophy on CT with progression documented
by serial observation
3. Other clinical features consistent with diagnosis of probable Alzheimers
disease, after exclusion of causes of dementia other than Alzheimers disease,
include:
-
Plateaus in course of progression of illness
-
Associated symptoms of depression; insomnia; incontinence; delusions; illusions;
hallucinations; catastrophic verbal, emotional, or physical outburst; sexual
disorders; and weight loss
-
Other neurological and analyses in some patients, especially with more advanced
disease and including motor signs, such as increased muscle tone, myoclonus,
or gait disorder
-
Seizures in advanced disease
-
CT normal for age
4. Features that make diagnosis of probable Alzheimers disease uncertain
or unlikely include:
-
Sudden apoplectic onset
-
Focal neurological findings such as hemiparesis, sensory loss, visual field
defects, and uncoordination early in the course of the illness
-
Seizures or gait disturbance at onset or very early in course of illness
5. Clinical diagnosis of possible Alzheimers disease:
-
May be made on basis of dementia syndrome, in absence of other neurological,
psychiatric, or systemic disorders sufficient to cause dementia and in the
presence of variations in onset, in presentation, or in clinical course
-
May be made in presence of second systemic or brain disorder sufficient to
produce dementia, which is not considered to be cause of dementia
-
Should be used in research studies when single, gradually progressive severe
cognitive deficit is identified in absence of other identifiable cause
6. Criteria for diagnosis of definite Alzheimers disease are:
-
Clinical criteria for probably Alzheimers disease
-
Histopathological evidence obtained from biopsy or at autopsy
7. Classification of Alzheimers disease for research purposes should specify
features that may differentiate subtypes of the disorders such as:
-
Familial occurrence
-
Onset before age of 65
-
Presence of Trisomy-21
-
Coexistence of other relevant conditions, such as Parkinson's disease
-
Alzheimers
(2000)
Mild Stage
-
Memory loss becomes more noticeable
-
Concentrating and paying attention becomes harder, leading to difficulties
in understanding written material, doing calculations, or making job-related
decisions
-
Misplacing or losing valuable items
-
Momentary disorientation in familiar surroundings
-
Some changes in personality and judgment
Moderate Stage
-
Memory loss about recent events and some details of personal lives
-
Inappropriate use of words
-
Difficulty in performing such tasks as planning meals and dressing
-
Increased disorientation
-
Agitation, anxiety, suspiciousness
-
Confusion between day and night
-
Sleep disturbances
-
Wandering off and not knowing how to return.
-
Failure to recognize friends and relatives
Severe Stage
