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Combining diagnostic tests more accurate at predicting Alzheimer's
Date:12/10/2012

, but the disease remains difficult to diagnose and patients are often misclassified.

"Misdiagnosis in very early stages of Alzheimer's is a significant problem, as there are more than 100 conditions that can mimic the disease. In people with mild memory complaints, our accuracy is barely better than chance. Given that the definitive gold standard for diagnosing Alzheimer's is autopsy, we need a better way to look into the brain," said P. Murali Doraiswamy, MBBS, professor of psychiatry and medicine at Duke and study author.

"Physicians vary widely in what tests they perform for diagnosis and prognosis of mild memory problems, which in turn affects decisions about work, family, treatment and future planning."

The Duke team analyzed data from 97 older adults with mild cognitive impairment from the Alzheimer's Disease Neuroimaging Initiative, a national study that collects data in hundreds of elderly patients with varying levels of cognitive impairment. Participants took part in clinical cognitive testing, as well as the three diagnostic exams: MRI, FDG-PET, and cerebrospinal fluid analysis. They then checked in with doctors for up to four years.

The misclassification rate based solely on neuropsychological testing and other clinical data was relatively high at 41.3 percent. Adding each of the diagnostic tests reduced the number of misdiagnoses so that, with all three tests combined, researchers achieved the lowest misclassification rate of 28.4%.

Of the three individual diagnostic tests, FDG-PET added the most information to clinical testing to detect early Alzheimer's in patients with mild cognitive impairment.

Researchers noted that while the tests clearly provided the most diagnostic information in combination, additional studies are needed to better understand their role in a clinical setting.

"The study used a unique data-mining algorithm to analyze MRI and PET images for 'silent' information th
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Contact: Rachel Bloch Harrison
rachel.harrison@duke.edu
919-419-5069
Duke University Medical Center
Source:Eurekalert

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