Table 2.

Epidemiological studies using CERAD batteries

Clinical Battery and Neuropsychology Battery used

Black/White dementia study P.Is.: A. Heyman, G. G. Fillenbaum Study based on participants of the Duke Established Populations for Epidemiologic Studies of the Elderly. Stratified random sample of 4,136 community residents (54% African American), age 65+, used to determine 3-year incidence of dementia; and 2-stage sample of those age 68+ to determine prevalence of dementia.66

Honolulu-Asia Aging Study (HAAS) P.I.: L. White Survey of 3,734 community and institutional resident Japanese-American men age 71–83, 80% of the survivors of the Honolulu Heart Program.67

Prevalence of Alzheimer’s Disease in Province (PREMAP) Random sample of 1062 residents (community and institution) age 70+ in south-eastern France. Evaluation of persons with MMSE<24 using CERAD batteries identified 177 cases of dementia (9.2%), including 82 cases of AD (5.5%). Prevalence of AD increased significantly with age and was higher among women (Odds Ratio: 4.24) and persons with no formal education (Odds Ratio: 2.47).68

Neuropsychology Battery only (entire battery, unless otherwise indicated)

Aging, Demographics, and Memory Study (ADAMS) P.Is.: R. Willis, B. Plassman First nationally representative, population-based, study in the U.S., designed to provide data on the antecedents, prevalence, outcomes and costs of dementia and of “cognitive impairment, not demented”. Sample of 856 participants in the Health and Retirement Study (age 70+).69

Cache County Study on Memory, Health and Aging P.Is.: J. Breitner, K. Welsh-Bohmer Continuing longitudinal study of 5,677 persons age 65+ who were permanent residents of Cache County, Utah, in order to ascertain the prevalence and incidence of dementia, and the development and impact of cognitive impairment.70–72

Chicago Health and Aging Project (CHAP) P.I.: D. A. Evans Longitudinal study of >6,000 residents (age 65+, 61% female, 62% African American, mean education 12 years), of three adjacent neighborhoods in Chicago. Data collection at ~3 year intervals, those who have reached age 65 since the previous interview date are then eligible to enroll, so maintaining the relevance of the sample.73

Duke Twins Study P.Is.: J. Breitner, B. Plassman Ongoing study of intact pairs of veteran twins in the National Academy of Sciences--National Research Council Registry aged 62–73 years in 1990–1991, to ascertain concordance for AD in twins as a function of age and apolipoprotein E genotype.74–75

Indianapolis-Ibadan Dementia Project P.Is.: H. C. Hendrie, K. Hall Sample of 2,494 Yoruba in Ibadan, Nigeria (age estimated from historic landmarks) and 2,318 community-resident and institutionalized African Americans in Indianapolis, Indiana, age 65+. Followup waves to identify incident dementia were conducted 2 and 5 years later, and are ongoing.76,77

Indo-US Cross-National Dementia Epidemiology Study P.I.: M. Ganguli Rural population (N=5,126) age 50+, 73% illiterate, of Ballabgarh, Northern India. (CERAD neuropsychology measures adapted to the rural Indian experience.)78

Kame project P.Is.: E.B. Larson, A.B. Graves (Borenstein) Survey of 1,985 community and institutional residents of King County, Washington State, age 65+. Nearly all 100% Japanese heritage, the remainder with minimum of 50% Japanese heritage.79

Korea Stratified cluster sample of 706 people age 65+ in Dong district of Gwangju, Korea, an urban area. (CERAD Word List tasks used to help identify presence of dementia.)80

Monongahela Valley Independent Elders Study (MoVIES) P.I.: M. Ganguli Longitudinal study of a random sample (N=1,350) of community residents age 65+ (6th grade education, except for very elderly), in rural area outside Pittsburgh, PA.81

Nun Study P.I.: D. A. Snowdon Longitudinal study of the School Sisters of Notre Dame (N=678; age 75–102 at entry). (Used selected CERAD neuropsychology measures.)82,83

Religious Orders Study P.I.: D. A. Bennett Nearly 1,000 older Catholic nuns, priests or brothers (mean age 76 years, mean education 18 years, 32% male, 11% minority), volunteers from about 40 groups in 12 states and the District of Columbia, who agreed to annual clinical evaluation and brain donation. (Used selected CERAD neuropsychology measures.)84

Rush Memory and Aging Project P.I.: D. A. Bennett More than 1,000 volunteers, mean age 81 years, 8% minority, 28% male, mean education 14 years (but a third had <12 years education), drawn from a variety of living arrangements, who agreed to detailed, repeated assessments, and donation of neurological material and muscle at death. (Used selected CERAD neuropsychology measures.)85

Taiwan Two-phase study of a stratified random sample of 2915 inhabitants age 65+ in southern Taiwan. Following initial screening, subjects were administered CERAD Neuropsychological Battery and neurobehavioral examination.86

Veterans Study of Memory in Aging P.I.: B. Plassman Carefully selected group of World War II Navy and Marine veterans hospitalized during military service with head injury, and controls. Complete information on 548 with and 1228 without head injury, used to ascertain risk for dementia as a function of head injury and apolipoprotein E status.87

Neuropathology battery

A review of population-based studies indicates that the CERAD Neuropathology Protocol appears to be the generally used standard.52

CERAD Neuropathology Protocol has been adopted by the College of American Pathologists for practice guidelines on autopsy pathology.44

The CERAD Neuropathology Protocol is the foundation for recommended diagnostic protocol for dementia with Lewy bodies.45

BrainNet Europe Consortium Comparison of inter-laboratory rating reliability based on the CERAD, Braak and Braak, and NIA-Reagan Institute neuropathologic criteria.88

Oxford Project to Investigate Memory and Aging (OPTIMA) Study in which by 1997, 200 patients with cognitive impairment or dementia had been referred by their physicians, and by 2002, 158 cognitively intact community residents age 60–91 had enrolled. CERAD neuropathological (and other criteria) were used.89

Religious Orders Study P.I.: D. A. Bennett (Used CERAD, NIA-Reagan, and Braak criteria.)84

U.K. Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) Neuropathology data come from decedents who participated in a longitudinal study of stratified random samples of residents age 65+ (>18,000 individuals) selected from 6 centers (including urban and rural areas) in the U.K.90

Behavior Rating Scale for Dementia

Alzheimer Disease Cooperative Study Representative studies: To examine emergence of behavioral pathology.91 Included, among other measures, to assess behavioral pathology.92 Incuded in the Alzheimer’s Disease Cooperative Study (ADCS) Instrument Development Project.93

Taiwan – survey of the prevalence of dementia Both the CERAD neuropsychology battery and the Behavior Rating Scale for Dementia were used in this survey.86