Clinical Approach to Diagnosis of Pre-Dementia Alzheimer’s Disease (CAD-PAD)

Abstract

Objective: Our aim was to evaluate clinical and neuropsychological features to identify pre-dementia Alzheimer’s disease (PAD) among mild cognitive impairment (MCI) patients. Methods: A longitudinal prospective study of 89 consecutive patients affected with MCI was conducted. Clinical evaluation consisted of a clinical interview protocol, neuropsychological evaluation, standard laboratory tests, and CT scan. A 6-month clinical check-up was made to determine whether patients remained in MCI, improved or progressed to AD or another dementia. Results: At 3-year follow-up, 47% patients developed AD dementia. Seventeen variables were significant and were evaluated by logistic regression analysis to identify the remaining optimal diagnostic criteria: age, gender, repeating comments, difficulties in understanding explanations, time of symptom evolution, history of depression, and word fluency (with animals) were identified with a sensitivity of 100% and a specificity of 93%. A computer application was developed with all these variables which we have named Clinical Approach to Diagnosis of PAD (CAD-PAD). Conclusions: These results suggest that CAD-PAD can help in the clinical diagnosis of PAD.

Keywords

• Clinical diagnosis
• Pre-dementia
• Alzheimer’s disease