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Very Mild Senile Dementia of the Alzheimer Type: I. Clinical Assessment

Very Mild Senile Dementia of the Alzheimer Type: I. Clinical Assessment Abstract • We report a longitudinal study of 16 subjects originally enrolled in the Washington University (St Louis, Mo) Memory and Aging Project with Clinical Dementia Rating (CDR) of "questionable" dementia (CDR 0.5). A 0.5 rating was intended to characterize subjects in whom mild cognitive impairment due to senile dementia of the Alzheimer type was suspected but was insufficient in degree to warrant a diagnosis of definite dementia. Over an 84-month follow-up period, 11 of the 16 subjects either had Alzheimer's disease verified post mortem or had clinically progressed to a more advanced CDR stage in which the dementia was clearly evident. These results suggest that the CDR 0.5 stage likely represents the incipient clinical manifestation of Alzheimer's disease and that the majority of subjects with CDR 0.5 have "very mild senile dementia of the Alzheimer type." Performance on several standard clinical scales was significantly different when comparing a larger sample of controls (n = 83), subjects with CDR 0.5 (n = 41), and subjects with mild senile dementia of the Alzheimer type (score of 1; n = 68). References 1. Berg L. The aging brain. In: Strong R, Wood WG, Burke W, Morrell RM, eds. Aging , vol 33. Central Nervous System Disorders of Aging: Clinical Intervention and Research . New York, NY: Raven Press; 1987:1-16. 2. Morris JC, Fulling K. Early Alzheimer's disease . Arch Neurol . 1988;45:345-349.Crossref 3. Morris JC, McKeel DW, Price JL, et al. Very mild senile dementia of the Alzheimer type . Neurology . 1988;38( (suppl 1) ):227.Crossref 4. Crook T, Bartus RT, Ferris SH, Whitehouse P, Cohen GD, Gershon S. Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change: report of a National Institute of Mental Health work group . Dev Neuropsychol . 1986;2:261-276.Crossref 5. Reisberg B, Ferris S, Franssen E, Kluger A, Borenstein J. Age-associated memory impairment: the clinical syndrome . Dev Neuropsychol . 1986;2:401-412.Crossref 6. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia . Br J Psychiatry . 1982;140:566-572.Crossref 7. Berg L. Clinical dementia rating . Br J Psychiatry . 1984;145:339. 8. Berg L. Mild senile dementia of the Alzheimer type: diagnostic criteria and natural history . Mt Sinai J Med . 1988;55:87-96. 9. Burke WJ, Miller JP, Rubin EH, et al. The reliability of the Washington University Clinical Dementia Rating . Arch Neurol . 1988;45:31-32.Crossref 10. Berg L, Hughes CP, Coben LA, Danziger WL, Martin RL, Knesevich JW. Mild senile dementia of Alzheimer type: research diagnostic criteria, recruitment, and description of a study population . J Neurol Neurosurg Psychiatry . 1982;45:962-968.Crossref 11. American Psychiatric Association Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders . 3rd ed. Washington, DC: American Psychiatric Association; 1980. 12. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's Disease . Neurology . 1984;34:39-44.Crossref 13. Morris JC, McKeel DW, Fulling K, Torack RM, Berg L. Validation of clinical diagnostic criteria for Alzheimer's disease . Ann Neurol . 1988;24:17-22.Crossref 14. Berg L, Miller JP, Storandt MA, et al. Mild senile dementia of the Alzheimer type, II: longitudinal assessment . Ann Neurol . 1988;23:477-484.Crossref 15. Storandt M, Hill R. Very mild dementia of the Alzheimer type, II: psychometric test performance . Arch Neurol . 1989;46:383-386.Crossref 16. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects . Br J Psychiatry . 1968;114:797-811.Crossref 17. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients . J Am Geriatr Soc . 1975;23:433-441. 18. Faber-Langendoen K, Morris JC, Knesevich JW, LaBarge E, Miller JP, Berg L. Aphasia in senile dementia of the Alzheimer type . Ann Neurol . 1988;23:365-370.Crossref 19. Katzman R, Brown T, Fuld P, Peck A, Schechter R, Schimmel H. Validation of a short orientation-memory-concentration test of cognitive impairment . Am J Psychiatry . 1983;140:734-739. 20. Rubin EH, Morris JC, Storandt M, Berg L. Behavioral changes in patients with mild senile dementia of the Alzheimer's type . Psychiatry Res . 1987;21:55-62.Crossref 21. Rubin EH, Morris JC, Berg L. The progression of personality changes in senile dementia of the Alzheimer type (SDAT) . J Am Geriatr Soc . 1987;35:721-725. 22. Rubin EH, Drevets WC, Burke WJ. The nature of psychotic symptoms in senile dementia of the Alzheimer type . J Geriatr Psychiatry Neurol . 1988;1:16-20.Crossref 23. Drevets WC, Rubin EH. Psychotic symptoms and the longitudinal course of senile dementia of the Alzheimer type . Biol Psychiatry . 1989;25:39-48.Crossref 24. Burke WJ, Rubin EH, Morris JC, Berg L. Symptoms of depression in senile dementia of the Alzheimer type . Alzheimer Disease and Associated Disorders . 1988;2:356-362.Crossref 25. Storandt M, Botwinick J, Danziger W, Berg L, Hughes CP. Psychometric differentiation of mild senile dementia of the Alzheimer type . Arch Neurol . 1984;41:497-499.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Very Mild Senile Dementia of the Alzheimer Type: I. Clinical Assessment

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1989.00520400033016
Publisher site
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Abstract

Abstract • We report a longitudinal study of 16 subjects originally enrolled in the Washington University (St Louis, Mo) Memory and Aging Project with Clinical Dementia Rating (CDR) of "questionable" dementia (CDR 0.5). A 0.5 rating was intended to characterize subjects in whom mild cognitive impairment due to senile dementia of the Alzheimer type was suspected but was insufficient in degree to warrant a diagnosis of definite dementia. Over an 84-month follow-up period, 11 of the 16 subjects either had Alzheimer's disease verified post mortem or had clinically progressed to a more advanced CDR stage in which the dementia was clearly evident. These results suggest that the CDR 0.5 stage likely represents the incipient clinical manifestation of Alzheimer's disease and that the majority of subjects with CDR 0.5 have "very mild senile dementia of the Alzheimer type." Performance on several standard clinical scales was significantly different when comparing a larger sample of controls (n = 83), subjects with CDR 0.5 (n = 41), and subjects with mild senile dementia of the Alzheimer type (score of 1; n = 68). References 1. Berg L. The aging brain. In: Strong R, Wood WG, Burke W, Morrell RM, eds. Aging , vol 33. Central Nervous System Disorders of Aging: Clinical Intervention and Research . New York, NY: Raven Press; 1987:1-16. 2. Morris JC, Fulling K. Early Alzheimer's disease . Arch Neurol . 1988;45:345-349.Crossref 3. Morris JC, McKeel DW, Price JL, et al. Very mild senile dementia of the Alzheimer type . Neurology . 1988;38( (suppl 1) ):227.Crossref 4. Crook T, Bartus RT, Ferris SH, Whitehouse P, Cohen GD, Gershon S. Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change: report of a National Institute of Mental Health work group . Dev Neuropsychol . 1986;2:261-276.Crossref 5. Reisberg B, Ferris S, Franssen E, Kluger A, Borenstein J. Age-associated memory impairment: the clinical syndrome . Dev Neuropsychol . 1986;2:401-412.Crossref 6. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia . Br J Psychiatry . 1982;140:566-572.Crossref 7. Berg L. Clinical dementia rating . Br J Psychiatry . 1984;145:339. 8. Berg L. Mild senile dementia of the Alzheimer type: diagnostic criteria and natural history . Mt Sinai J Med . 1988;55:87-96. 9. Burke WJ, Miller JP, Rubin EH, et al. The reliability of the Washington University Clinical Dementia Rating . Arch Neurol . 1988;45:31-32.Crossref 10. Berg L, Hughes CP, Coben LA, Danziger WL, Martin RL, Knesevich JW. Mild senile dementia of Alzheimer type: research diagnostic criteria, recruitment, and description of a study population . J Neurol Neurosurg Psychiatry . 1982;45:962-968.Crossref 11. American Psychiatric Association Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders . 3rd ed. Washington, DC: American Psychiatric Association; 1980. 12. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's Disease . Neurology . 1984;34:39-44.Crossref 13. Morris JC, McKeel DW, Fulling K, Torack RM, Berg L. Validation of clinical diagnostic criteria for Alzheimer's disease . Ann Neurol . 1988;24:17-22.Crossref 14. Berg L, Miller JP, Storandt MA, et al. Mild senile dementia of the Alzheimer type, II: longitudinal assessment . Ann Neurol . 1988;23:477-484.Crossref 15. Storandt M, Hill R. Very mild dementia of the Alzheimer type, II: psychometric test performance . Arch Neurol . 1989;46:383-386.Crossref 16. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects . Br J Psychiatry . 1968;114:797-811.Crossref 17. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients . J Am Geriatr Soc . 1975;23:433-441. 18. Faber-Langendoen K, Morris JC, Knesevich JW, LaBarge E, Miller JP, Berg L. Aphasia in senile dementia of the Alzheimer type . Ann Neurol . 1988;23:365-370.Crossref 19. Katzman R, Brown T, Fuld P, Peck A, Schechter R, Schimmel H. Validation of a short orientation-memory-concentration test of cognitive impairment . Am J Psychiatry . 1983;140:734-739. 20. Rubin EH, Morris JC, Storandt M, Berg L. Behavioral changes in patients with mild senile dementia of the Alzheimer's type . Psychiatry Res . 1987;21:55-62.Crossref 21. Rubin EH, Morris JC, Berg L. The progression of personality changes in senile dementia of the Alzheimer type (SDAT) . J Am Geriatr Soc . 1987;35:721-725. 22. Rubin EH, Drevets WC, Burke WJ. The nature of psychotic symptoms in senile dementia of the Alzheimer type . J Geriatr Psychiatry Neurol . 1988;1:16-20.Crossref 23. Drevets WC, Rubin EH. Psychotic symptoms and the longitudinal course of senile dementia of the Alzheimer type . Biol Psychiatry . 1989;25:39-48.Crossref 24. Burke WJ, Rubin EH, Morris JC, Berg L. Symptoms of depression in senile dementia of the Alzheimer type . Alzheimer Disease and Associated Disorders . 1988;2:356-362.Crossref 25. Storandt M, Botwinick J, Danziger W, Berg L, Hughes CP. Psychometric differentiation of mild senile dementia of the Alzheimer type . Arch Neurol . 1984;41:497-499.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Apr 1, 1989

References