Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Foreword RAYMOND LEVY
- Acknowledgements
- Part 1 Modern methods of neuroimaging
- Part 2 Neuroimaging in specific psychiatric disorders of late life
- 2 The normal elderly
- 3 Alzheimer's disease
- 4 Vascular dementia
- 5 Other dementias
- 6 Delirium
- 7 Affective disorders
- 8 Paranoid and schizophrenic disorders of late life
- Part 3 Clinical guidelines
- Index
3 - Alzheimer's disease
from Part 2 - Neuroimaging in specific psychiatric disorders of late life
Published online by Cambridge University Press: 15 January 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Foreword RAYMOND LEVY
- Acknowledgements
- Part 1 Modern methods of neuroimaging
- Part 2 Neuroimaging in specific psychiatric disorders of late life
- 2 The normal elderly
- 3 Alzheimer's disease
- 4 Vascular dementia
- 5 Other dementias
- 6 Delirium
- 7 Affective disorders
- 8 Paranoid and schizophrenic disorders of late life
- Part 3 Clinical guidelines
- Index
Summary
Introduction
Alzheimer's disease (AD) is characterized clinically by the presence of a dementia syndrome and by the absence of other specific causes of dementia (Burns & Förstl, 1994; McKhann et al., 1984). Diagnostic criteria have been developed with the aim of predicting accurately who will have the pathological hallmarks of AD at postmortem. One of the most widely quoted set of guidelines is those of the National Institute for Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Associated Disorders Association (NINCDS/ADRDA, McKhann et al., 1984), which are divided into ‘definite’ (autopsy confirmed), ‘probable’ and ‘possible’ criteria. The clinical suspicion of AD can only be verified by neuropathological examination of brain tissue. Similar to the clinician, the neuropathologist has to rely on inclusion and exclusion criteria, quantify the histopathological hallmarks and rule out other diseases that may significantly contribute to the clinical syndrome. Clinical and neuropathological criteria are essentially arbitrary but validation of each against the other is a legitimate attempt to achieve validity. Discrimination of AD from normal aging and other forms of dementia is the ultimate aim of such studies.
Normal neuroradiological and electrophysiological findings or nonspecific changes are compatible with a diagnosis of probable AD, whereas evidence of severe vascular changes, space-occupying lesions or Creutzfeldt–Jakob disease is not. The primary goal of such investigations in demented patients is the detection of treatable associated or accompanying illnesses.
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- Information
- Neuroimaging and the Psychiatry of Late Life , pp. 100 - 121Publisher: Cambridge University PressPrint publication year: 1997