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P2‐191: Early Onset Alzheimer's Disease is Overrepresented in Yemenite Jewish Descendants Compared to Other Ethnic Groups: 20 Years' Experience in a Tertiary Center
Author(s) -
Keret Ophir,
Treves Therese A.,
Steiner Israel,
Glik Amir
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.1358
Subject(s) - dementia , medicine , cohort , population , ethnic group , disease , pediatrics , depression (economics) , demography , sociology , anthropology , environmental health , economics , macroeconomics
Background:Major consensus criteria currently in use include: (1) National Institute on Aging-Alzhiemer’s Association (NIA-AA), (2) International Working Group (IWG), (3) International Classification of Diseases (ICD-10), and (4) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The National Institute of Neurological and Communicative Disorders – Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criterion remains an important comparator standard given its role in AD research prior to the advent of the newer, biomarker-driven criteria. A preliminary study of participants from the Sunnybrook Dementia Study (SDS; ClinicalTrials.gov NCT01800214) demonstrated notable discordance between criteria, in particular between the subtype and co-pathology permissive NIA-AA, and the prototypic and biomarker-requiring IWG. This study examines diagnostic agreement between these new criteria and the NINCDS-ADRDA “bronze standard”. Methods:A convenience sample of 155 participants from the SDS who met NINCDS-ADRDA criteria for probable or possible AD was reviewed retrospectively. Data included clinical history, function (Alzheimer’s Disease Functional Assessment of Change Scale), cognitive screening (MMSE and Behavioural Neurology Assessment), cognitive testing (Dementia Rating Scale), MRI, and single photo emission computed tomography (SPECT). SPECT was used in place of FDG-PET when applying the NIA-AA and IWG criteria. Results:Diagnostic re-classification by new criteria is show in Table 1 and Table 2. Comparing across broad diagnostic categories (AD vs. not AD), agreement with the NINCDS-ADRDA was best for the NIA-AA (94%) and DSM-5 (96%), and poor for the IWG-1 (54%) and ICD-10 (55%). Agreement with the NINCDS-ADRDA probable AD subgroup was better for the IWG (76%) and ICD-10 (71%), and much worse for the possible AD subgroup – IWG (13%) and ICD-10 (27%). Conclusions: Individuals diagnosed with AD by the NINCDS-ADRDA will generally still be diagnosed with AD by the NIA-AA and DMS-5. However, a significant portion will not, using the IWG or ICD-10, especially among those previously diagnosed with only possible disease.