Open AccessDetermining the impact of psychosis on rates of false‐positive and false‐negative diagnosis in Alzheimer's disease
Author(s) -
Fischer Corinne E.,
Qian Winnie,
Schweizer Tom A.,
Ismail Zahinoor,
Smith Eric E.,
Millikin Colleen P.,
Munoz David G.
Publication year - 2017
Publication title -
alzheimer's and dementia: translational research and clinical interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.49
H-Index - 30
ISSN - 2352-8737
DOI - 10.1016/j.trci.2017.06.001
Subject(s) - neuropathology , psychosis , false positive paradox , dementia , pathological , autopsy , dementia with lewy bodies , psychiatry , disease , medicine , alzheimer's disease , false positive rate , vascular dementia , psychology , pathology , statistics , mathematics , machine learning , computer science
The rate of clinical misdiagnosis of Alzheimer's disease (AD) and how psychosis impacts that clinical judgment is unclear. Methods Using data from National Alzheimer's Coordinating Center, we compared the clinical and neuropathologic diagnosis in patients with a diagnosis of AD with autopsy and in neuropathology‐confirmed AD cases ( n = 961). We determined the rate of true positives, false positives, and false negatives in patients with and without psychosis. Results A total of 76% received a correct AD diagnosis, 11.9% had a false‐negative diagnosis, and 12.1% had a false‐positive diagnosis of AD. Psychotic patients had a higher rate of false‐negative diagnosis and a lower rate of false‐positive diagnosis of AD compared with nonpsychotic patients. Discussion Patients with psychosis were five times more likely to be misdiagnosed as dementia with Lewy bodies, whereas patients without psychosis were more likely to be falsely diagnosed with AD when vascular pathology is the underlying neuropathologic cause of dementia.