Abstract
To find out whether the diagnosis of dementia agreed with findings at necropsy a detailed assessment of 27 elderly patients (mean age 82 (range 70-94] presenting with dementia was conducted at a combined department of geriatric medicine and psychiatry for the elderly. On the basis of the results the cause of the dementia was diagnosed clinically. Neuropathological examinations were performed after death. The clinical diagnosis made during life was not supported by the findings at necropsy in 11 cases. Alzheimer's disease was overdiagnosed in life (13 cases, of which only six were confirmed at necropsy). Although the clinical investigation was limited by availability of resources, neither cranial computed tomography nor the Hachinski score helped to distinguish between multi-infarct dementia and Alzheimer's disease in this age group. This study confirms the value of neuropathological studies in the precise diagnosis of dementia.
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- Erkinjuntti T., Wikström J., Palo J., Autio L. Dementia among medical inpatients. Evaluation of 2000 consecutive admissions. Arch Intern Med. 1986 Oct;146(10):1923–1926. [PubMed] [Google Scholar]
- Gustafson L., Nilsson L. Differential diagnosis of presenile dementia on clinical grounds. Acta Psychiatr Scand. 1982 Mar;65(3):194–209. doi: 10.1111/j.1600-0447.1982.tb00840.x. [DOI] [PubMed] [Google Scholar]
- Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
- Harrison M. J., Thomas D. J., Du Boulay G. H., Marshall J. Multi-infarct dementia. J Neurol Sci. 1979 Feb;40(2-3):97–103. doi: 10.1016/0022-510x(79)90195-3. [DOI] [PubMed] [Google Scholar]
- Henderson A. S. The epidemiology of Alzheimer's disease. Br Med Bull. 1986 Jan;42(1):3–10. doi: 10.1093/oxfordjournals.bmb.a072095. [DOI] [PubMed] [Google Scholar]
- KAY D. W., BEAMISH P., ROTH M. OLD AGE MENTAL DISORDERS IN NEWCASTLE UPON TYNE. I. A STUDY OF PREVALENCE. Br J Psychiatry. 1964 Mar;110:146–158. doi: 10.1192/bjp.110.465.146. [DOI] [PubMed] [Google Scholar]
- Larson E. B., Reifler B. V., Featherstone H. J., English D. R. Dementia in elderly outpatients: a prospective study. Ann Intern Med. 1984 Mar;100(3):417–423. doi: 10.7326/0003-4819-100-3-417. [DOI] [PubMed] [Google Scholar]
- Liston E. H., La Rue A. Clinical differentiation of primary degenerative and multi-infarct dementia: a critical review of the evidence. Part II: Pathological studies. Biol Psychiatry. 1983 Dec;18(12):1467–1484. [PubMed] [Google Scholar]
- MARSLAND T. A., GLEES P., ERIKSON L. B. Modification of the Glees silver impregnation for paraffin sections. J Neuropathol Exp Neurol. 1954 Oct;13(4):587–591. doi: 10.1097/00005072-195410000-00005. [DOI] [PubMed] [Google Scholar]
- Mulley G. P. Differential diagnosis of dementia. Br Med J (Clin Res Ed) 1986 May 31;292(6533):1416–1418. doi: 10.1136/bmj.292.6533.1416. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mölsä P. K., Paljärvi L., Rinne J. O., Rinne U. K., Säkö E. Validity of clinical diagnosis in dementia: a prospective clinicopathological study. J Neurol Neurosurg Psychiatry. 1985 Nov;48(11):1085–1090. doi: 10.1136/jnnp.48.11.1085. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith J. S., Kiloh L. G., Ratnavale G. S., Grant D. A. The investigation of dementia: the results in 100 consecutive admissions. Med J Aust. 1976 Sep 11;2(11):403–405. doi: 10.5694/j.1326-5377.1976.tb130285.x. [DOI] [PubMed] [Google Scholar]
- Sulkava R. Alzheimer's disease and senile dementia of Alzheimer type. A comparative study. Acta Neurol Scand. 1982 Jun;65(6):636–650. doi: 10.1111/j.1600-0404.1982.tb03117.x. [DOI] [PubMed] [Google Scholar]
- Sulkava R., Haltia M., Paetau A., Wikström J., Palo J. Accuracy of clinical diagnosis in primary degenerative dementia: correlation with neuropathological findings. J Neurol Neurosurg Psychiatry. 1983 Jan;46(1):9–13. doi: 10.1136/jnnp.46.1.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Summers W. K., Majovski L. V., Marsh G. M., Tachiki K., Kling A. Oral tetrahydroaminoacridine in long-term treatment of senile dementia, Alzheimer type. N Engl J Med. 1986 Nov 13;315(20):1241–1245. doi: 10.1056/NEJM198611133152001. [DOI] [PubMed] [Google Scholar]
- Tomlinson B. E., Blessed G., Roth M. Observations on the brains of demented old people. J Neurol Sci. 1970 Sep;11(3):205–242. doi: 10.1016/0022-510x(70)90063-8. [DOI] [PubMed] [Google Scholar]