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Clinicopathological concordance in dementia diagnostics.

Brunnström, Hans LU orcid and Englund, Elisabet LU orcid (2009) In The American Journal of Geriatric Psychiatry 17(8). p.664-670
Abstract
OBJECTIVE: Accurate distinction between dementia subtypes is important for patient care and pharmacological treatment. Continuing systematic comparisons of clinical and neuropathological dementia diagnoses may provide a basis for further improvement of the diagnostic procedure. The purpose of this study was to investigate concordance between clinical dementia diagnosis and neuropathological findings in the specialized dementia care. METHODS: Inclusion required 1) a clinical dementia disorder diagnosed at a hospital-based memory clinic and 2) a neuropathological examination within the Department of Pathology at the University Hospital in Lund, Sweden, during the years 1996-2006. A total of 176 consecutive patients fulfilled the criteria and... (More)
OBJECTIVE: Accurate distinction between dementia subtypes is important for patient care and pharmacological treatment. Continuing systematic comparisons of clinical and neuropathological dementia diagnoses may provide a basis for further improvement of the diagnostic procedure. The purpose of this study was to investigate concordance between clinical dementia diagnosis and neuropathological findings in the specialized dementia care. METHODS: Inclusion required 1) a clinical dementia disorder diagnosed at a hospital-based memory clinic and 2) a neuropathological examination within the Department of Pathology at the University Hospital in Lund, Sweden, during the years 1996-2006. A total of 176 consecutive patients fulfilled the criteria and were thus included. Clinical dementia diagnoses were obtained from the medical records and compared with the neuropathological findings. RESULTS: The clinical and pathological dementia diagnoses were in full accordance in 86 (49%) of the patients (kappa 0.37). In an additional 24 (14%) cases, the clinical diagnosis corresponded with some but not all pathological components judged to contribute to the dementia disorder. Of the patients with clinical Alzheimer disease, 84% (46/55) had a significant Alzheimer component with or without other significant pathology at neuropathological examination. The corresponding figure for vascular dementia (VaD) was 59% (24/41), for frontotemporal dementia 74% (20/27), for combined Alzheimer and VaD 25% (4/16), and for dementia with Lewy bodies 67% (6/9). CONCLUSIONS: This study shows that clinical dementia diagnoses do not always correspond with neuropathological changes. It stresses the importance of neuropathological examination in research and in daily clinical practice. (Less)
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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The American Journal of Geriatric Psychiatry
volume
17
issue
8
pages
664 - 670
publisher
Elsevier
external identifiers
  • wos:000268428000005
  • pmid:19634210
  • scopus:68449095059
ISSN
1545-7214
DOI
10.1097/JGP.0b013e3181a6516e
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000)
id
b71778c4-71b4-43ba-b688-c77684836f6f (old id 1452754)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19634210?dopt=Abstract
date added to LUP
2016-04-04 08:33:15
date last changed
2025-04-04 14:39:14
@article{b71778c4-71b4-43ba-b688-c77684836f6f,
  abstract     = {{OBJECTIVE: Accurate distinction between dementia subtypes is important for patient care and pharmacological treatment. Continuing systematic comparisons of clinical and neuropathological dementia diagnoses may provide a basis for further improvement of the diagnostic procedure. The purpose of this study was to investigate concordance between clinical dementia diagnosis and neuropathological findings in the specialized dementia care. METHODS: Inclusion required 1) a clinical dementia disorder diagnosed at a hospital-based memory clinic and 2) a neuropathological examination within the Department of Pathology at the University Hospital in Lund, Sweden, during the years 1996-2006. A total of 176 consecutive patients fulfilled the criteria and were thus included. Clinical dementia diagnoses were obtained from the medical records and compared with the neuropathological findings. RESULTS: The clinical and pathological dementia diagnoses were in full accordance in 86 (49%) of the patients (kappa 0.37). In an additional 24 (14%) cases, the clinical diagnosis corresponded with some but not all pathological components judged to contribute to the dementia disorder. Of the patients with clinical Alzheimer disease, 84% (46/55) had a significant Alzheimer component with or without other significant pathology at neuropathological examination. The corresponding figure for vascular dementia (VaD) was 59% (24/41), for frontotemporal dementia 74% (20/27), for combined Alzheimer and VaD 25% (4/16), and for dementia with Lewy bodies 67% (6/9). CONCLUSIONS: This study shows that clinical dementia diagnoses do not always correspond with neuropathological changes. It stresses the importance of neuropathological examination in research and in daily clinical practice.}},
  author       = {{Brunnström, Hans and Englund, Elisabet}},
  issn         = {{1545-7214}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{664--670}},
  publisher    = {{Elsevier}},
  series       = {{The American Journal of Geriatric Psychiatry}},
  title        = {{Clinicopathological concordance in dementia diagnostics.}},
  url          = {{http://dx.doi.org/10.1097/JGP.0b013e3181a6516e}},
  doi          = {{10.1097/JGP.0b013e3181a6516e}},
  volume       = {{17}},
  year         = {{2009}},
}