Do NIA-AA criteria distinguish Alzheimer's disease from frontotemporal dementia?

Abstract

Background: Clinical criteria are important for improving diagnostic accuracy and ensuring comparability of patient cohorts in research studies.

Objective: The aim was to assess the National Institute on Aging and Alzheimer's Association (NIA-AA) criteria for Alzheimer's disease (AD) dementia in AD and frontotemporal lobar degeneration (FTLD).

Methods: Two hundred twelve consecutive patients with pathologically confirmed AD or FTLD who were clinically assessed in a specialist cognitive unit were identified. Fifty-five patients were excluded predominantly because of insufficient clinical information. Anonymized clinical data were rated against the NIA-AA criteria by raters who were blinded to clinical and pathologic diagnosis.

Results: The NIA-AA AD dementia criteria had a sensitivity of 65.6% for probable and 79.5% for possible AD and a specificity of 95.2% and 94.0% for probable and possible, respectively.

Conclusion: In patients with FTLD and predominantly early-onset AD, the NIA-AA AD dementia criteria have high specificity but lower sensitivity. The high specificity is due to the broad exclusion criteria.

Keywords: Alzheimer's disease; Criteria; Dementia; Diagnosis; Neuropathology; Pathology.