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Department of Neurology, Pittsburgh (University Drive) Veterans Administration Medical Center(Drs. Boller, Lopez, and Moossy)
Department of Psychiatry, Pittsburgh (University Drive) Veterans Administration Medical Center (Dr. Boiler)
Department of Pathology (Division of Neuropathology), University of Pittsburgh Medical School, Pittsburgh, PA. (Dr. Moossy)
Pittsburgh Alzheimer Disease Research Center, University of Pittsburgh Medical School, Pittsburgh, PA. (Drs. Boiler, Lopez, and Moossy)
Based on 54 demented patients consecutively autopsied at the University of Pittsburgh, we studied the accuracy of clinicians in predicting the pathologic diagnosis. Thirty-nine patients (72.2%) had Alzheimer's disease, while 15 (27.7%) had other CNS diseases (four multi-infarct dementia; three Creutzfeldt-Jakob disease; two thalamic and subcortical gliosis; three Parkinson's disease; one progressive supranuclear palsy; one Huntington's disease; and one unclassified). Two neurologists independently reviewed the clinical records of each patient without knowledge of the patient's identity or clinical or pathologic diagnoses; each clinician reached a clinical diagnosis based on criteria derived from those of the NINCDS/ADRDA. In 34 (63%) cases both clinicians were correct, in nine (17%) one was correct, and in 11 (20%) neither was correct. These results show that in patients with a clinical diagnosis of dementia, the etiology cannot be accurately predicted during life.
Address correspondence and reprint requests to Dr. Boller, Department of Neurology, 322 Scaife Hall, University of Pittsburgh Medical School, Pittsburgh, PA 15261.
Supported in part by NIH Grants nos. AG05133 and AG03705, NIMH Grant no. MH30915, by funds from the Veterans Administration, and by the Pathology Education and Research Foundation (PERF) of the Department of Pathology, University of Pittsburgh.
Presented in part at the fortieth annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.
Received April 7, 1988. Accepted for publication in final form July 20, 1988.
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