Determining the impact of psychosis on rates of false‐positive and false‐negative diagnosis in Alzheimer's disease

Alzheimer's and Dementia: Translational Research and Clinical Interventions - Tập 3 - Trang 385-392 - 2017
Corinne E. Fischer1,2, Winnie Qian1,2, Tom A. Schweizer1,3,4,5,6, Zahinoor Ismail7,8, Eric E. Smith9, Colleen P. Millikin10, David G. Munoz1,11,12
1Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
2Faculty of Medicine, Division of Geriatric Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
3Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
4Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
5Faculty of Medicine, Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
6Division of Neurosurgery, St Michael's Hospital, Toronto, Ontario, Canada
7Department of Psychiatry, Mathison Centre for Mental Health Research & Education, Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
8Department of Neurology, Mathison Centre for Mental Health Research & Education, Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
9Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
10Department of Clinical Healthy Psychology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
11Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
12Division of Pathology, St. Michael's Hospital, Toronto, Ontario, Canada

Tóm tắt

AbstractIntroductionThe rate of clinical misdiagnosis of Alzheimer's disease (AD) and how psychosis impacts that clinical judgment is unclear.MethodsUsing data from National Alzheimer's Coordinating Center, we compared the clinical and neuropathologic diagnosis in patients with a diagnosis of AD with autopsy and in neuropathology‐confirmed AD cases (n = 961). We determined the rate of true positives, false positives, and false negatives in patients with and without psychosis.ResultsA total of 76% received a correct AD diagnosis, 11.9% had a false‐negative diagnosis, and 12.1% had a false‐positive diagnosis of AD. Psychotic patients had a higher rate of false‐negative diagnosis and a lower rate of false‐positive diagnosis of AD compared with nonpsychotic patients.DiscussionPatients with psychosis were five times more likely to be misdiagnosed as dementia with Lewy bodies, whereas patients without psychosis were more likely to be falsely diagnosed with AD when vascular pathology is the underlying neuropathologic cause of dementia.

Tài liệu tham khảo

Alzheimer's Disease International.World Alzheimer Report 2011.2011 Available at:https://www.alz.co.uk/research/WorldAlzheimerReport2011.pdf Accessed July 11 2016 10.1016/j.jalz.2015.06.1889 10.1097/JGP.0b013e3181a6516e 10.1002/ana.410350113 10.1212/WNL.40.1.1 10.1097/NEN.0b013e31824b211b 10.1176/appi.ajp.2013.13040466 10.1016/j.neurobiolaging.2014.03.003 10.1517/14740338.2010.506711 10.1177/0891988710373596 10.1159/000113418 10.3233/JAD-150606 10.1016/j.jalz.2013.01.015 10.1371/journal.pone.0109484 10.1586/ern.11.6 10.1093/jnen/nlw033 10.1016/j.jalz.2015.12.006 10.1097/01.wad.0000213865.09806.92 10.1212/WNL.34.7.939 1997, Consensus recommendations for the postmortem diagnosis of Alzheimer's disease. The National Institute on Aging, and Reagan Institute Working Group on Diagnostic Criteria for the Neuropathological Assessment of Alzheimer's Disease, Neurobiol Aging, 18, S1 10.1212/01.wnl.0000187889.17253.b1 Cummings J.L., 1996, Neuropsychiatric syndromes in neurodegenerative disease: frequency and significance, Semin Clin Neuropsychiatry, 1, 241 10.1176/appi.ajp.162.11.2022 Weamer E.A., 2016, Incident psychosis in mild cognitive impairment and Alzheimer's disease subjects, J Clin Psychiatry, 77, e1564, 10.4088/JCP.15m10617 10.3233/JAD-130596 10.1176/appi.ajp.2014.14040480 10.1017/S0033291700034942
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Alzheimer's and Dementia: Translational Research and Clinical Interventions

Tập 3

385-392

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