Autopsy-confirmed Alzheimer's disease versus clinically diagnosed Alzheimer's disease in the Cache County Study on Memory and Aging: A comparison of quantitative MRI and neuropsychological findings

Abstract

Atrophy of specific, regional, and generalized brain structures occurs as a result of the Alzheimer's disease (AD) process. Comparing AD patients with histopathological confirmation of the disease at autopsy to those without autopsy but who were clinically diagnosed using the same antemortem criteria will provide further evidence of the utility and accuracy of neuropsychological assessments at the time of diagnosis, as well as the efficacy of quantitative magnetic resonance imaging (qMRI) in demonstrating gross neuropathological changes associated with the disease. The Cache County Study of Aging provides a unique opportunity to determine how closely AD subjects with only the clinical diagnosis match similarly diagnosed AD subjects but with postmortem confirmation of the disease. qMRI volumes of various brain structures, as well as neuropsychological outcome measures from an expanded battery, were obtained in 31 autopsy-confirmed AD subjects and 45 clinically diagnosed AD subjects. Of the various qMRI variables examined, only total temporal lobe volume was different, where those with postmortem confirmation had reduced volume. No significant differences between the two groups were found with any of the neuropsychological outcome measures. These findings confirm the similarity in neuroimaging and neuropsychological assessment findings between those with just the clinical diagnosis of AD and those with an autopsy-confirmed diagnosis in the moderate-to-severe stage of the disease at the time of diagnosis.

This study was supported in part by National Institute of Health Grant AG-11380 and the Ira Fulton Foundation; the editorial assistance of Jo Ann Petrie is also greatly appreciated.

Notes

*Cache County Investigators: James Anthony; Ron Brookmeyer; James Burke; Michelle Carlson; Eric Christopher; Chris Corcoran; Marion David; Jane Gagliardi; Robert Green; Andrea Hart; Michael Helms; Christine Hulette; Liz Klein; Carole Leslie; John Morris; Ron Munger; Chiadi Onyike; Truls Østbye; Ron Petersen; Kathy Piercy; Carl Pieper; Brenda Plassman; Peter Rabins; Pritham Raj; Russell Ray; Linda Sanders; David C. Steffens; Martin Steinberg; Marty Toohill; Leslie Toone; Jeannette J. Townsend; Heidi Wengreen; Nancy West; Michael Williams; and Bonita W. Wyse.