NEUROPATHOLOGIC DIAGNOSTIC OUTCOMES FROM A COHORT OF OUTPATIENTS WITHSUSPECTED DEMENTIA

Background. Researchers, clinicians, patients, and families need to kn ow the accuracy of clinical dementia diagnoses. Methods. A prospective cohort of outpatients presenting with complaints of cognitive impairm ent to a geriatric clinic was established from 1978 to 1982. All patie nts initially received a standardized clinical evaluation and then wer e followed longitudinally. Results. Of 304 patients originally enrolle d, 72 have come to autopsy and neuropathologic evaluation. Of those pa tients, 56 had been clinically diagnosed with Alzheimer's disease (AD) and 16 had been diagnosed with other conditions. The sensitivity, spe cificity, and diagnostic accuracy of the clinical diagnosis of AD comp ared with neuropathologic diagnosis was 95%, 81%, and 92%, respectivel y. Conclusion. Our findings support the conclusion that the practicing clinician using standardized clinical criteria can accurately diagnos e AD approximately 90% of the time. These data may also be useful in t he planning of future care of the AD patient.