Current diagnostic methods and outcome variables for clinical investigation of Alzheimer’s disease

  • S. Gauthier
  • M. Panisset
Part of the Journal of Neural Transmission. Supplementa book series (NEURAL SUPPL, volume 53)


The diagnosis of Alzheimer’s disease (AD) is done by a careful history, requiring reliable informants and serial observations. The main differential diagnosis is depression, delirium, and inappropriate use of psychotropic drugs. Other common causes of dementia such as vascular, Lewy body disease, frontal lobe degeneration, can be distinguished by the pattern of symptoms and findings on the physical examination. A minimal amount of laboratory investigation is usually required.

The natural history of AD, with progressive involvement of cognition, activities of daily living and behaviour, justifies the need of outcome variables addressing these specific symptomatic domains. These are complemented by global clinical assessment tools for disease staging and disease progression. A new challenge is to select from outcome variables used in clinical investigations the most appropriate tools for regular clinical practice.


Lewy Body Disease Clock Drawing Test Main Differential Diagnosis Severe Impairment Battery Instrumental Task 


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  1. Aisen PS, Devis KL (1997) The search for disease-modifying treatment for Alzheimer’s disease. Neurology 48 [Suppl 6]: S35-S41Google Scholar
  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. APA, Washington DCGoogle Scholar
  3. Bouchard RW, Rosser MN (1996) Typical clinical features. In: Clinical diagnosis and management of Alzheimer’s disease. Martin Dunitz, London, pp 35–30Google Scholar
  4. Clarfield AM (1988) The reversible dementias: do they reverse? Ann Int Med 15: 476–486Google Scholar
  5. Fontaine S, Nordbert A (1996) Brain imaging. In: Clinical diagnosis and management of Alzheimer’s disease. Martin Dunitz, London, pp 83–105Google Scholar
  6. Gauthier S, Panisset M, Nalbantoglu J, Poirier J (1997) Alzheimer’s disease: current knowledge, management and research. Can Med Assoc J 157: 1047–1052Google Scholar
  7. Gélinas I, Auer S (1996) Functional autonomy. In: Clinical diagnosis and management of Alzheimer’s disease. Martin Dunitz, London, pp 191–202Google Scholar
  8. Green RC, Clarke VC, Thompson NJ, Woodard JL, Letz R (1997) Early detection of Alzheimer disease: methods, markers and misgivings. Alzheim Dis Assoc Disord 11 [Suppl 5]: S1–S5Google Scholar
  9. Kertesz A, Mohs RC (1996) Cognition. In: Clinical diagnosis and management of Alzheimer’s disease. Martin Dunitz, London, pp 155–174Google Scholar
  10. McKhann G, Drachman D, Folstein M, et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA workgroup. Neurology 34: 939–944PubMedCrossRefGoogle Scholar
  11. Panisset M, Roudier M, Saxton J, Boiler F (1994) Severe Impairment Battery: a neuropsychological test for severely demented patients. Arch Neurol 51: 41–45PubMedCrossRefGoogle Scholar
  12. Rossor MN, Fox NC, Freeborough PA, Rogues PK (1997) Slowing the progression of Alzheimer disease: monitoring progression. Alzheim Dis Assoc Disord 11 [Suppl 5]: S6–9Google Scholar
  13. Schneider LS, Olin JT, Doody RS, Clark CM, Morris JC, Reisberg B, Schmitt FA, Grudman M, Thomas RG, Ferris SH (1997) Validity and reliability of the ADCS-CGIC. Alzheim Dis Assoc Disord 11 [Suppl 2]: S22–32CrossRefGoogle Scholar
  14. Thalman B, Mansch AU, Ermini-Fiinfschilling D, et al (1996) Improved screening for dementia: combining the clock drawing test and the mini-mental status examination. Presented at the 4th International Nice/Springfield Alzheimer Symposium, Nice, 10-14 April 1996Google Scholar

Copyright information

© Springer-Verlag Wien 1998

Authors and Affiliations

  • S. Gauthier
    • 1
  • M. Panisset
    • 1
  1. 1.Centre for Studies in AgingMcGill UniversityVerdunCanada

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