Recommendati ons for the Di agnosis and Management of Alzheimer’s Dise ase and Other Disorders Associ ated with Dementi a

Czech version

Authors: P. Ressner ¹; J. Hort ²; I. Rektorová ³; A. Bartoš ^4,5; R. Rusina ^6,7; V. Línek ⁸; K. She ardová ³; Za Sekci Kognitivní Ne urologi e České Ne urologické Společnosti J. E. P.
Authors‘ workplace: Ne urologické oddělení, Nemocnice s polikliniko u v Novém Jičíně ¹; Ne urologická klinika 2. LF UK a FN v Motole, Praha ²; I. ne urologická klinika LF MU, FN u sv. Anny v Brně ³; Ne urologická klinika 3. LF UK a FN Královské Vinohrady, Praha ⁴; Psychi atrické centrum Praha ⁵; Ne urologická klinika FTNsP, Praha ⁶; Institut postgraduálního vzdělávání ve zdravotnictví, Praha ⁷; Ne urologická klinika 1. LF UK, VFN, Praha ⁸
Published in: Cesk Slov Neurol N 2008; 71/104(4): 494-501
Category: Recommendation

Overview

Backgro und:
The aim of this guideline for di agnosis of dementi a is to present a peer- revi ewed and evidence‑based statement in order to guide the practice of ne urologists, geri atrici ans, psychi atrists, and other speci alised physici ans responsible for the care of pati ents with dementi a. The main focus is the di agnosis of Alzheimer’s dise ase, but many of the recommendati ons apply to dementi a disorders in general.

Methods:
The materi al is derived from a revisi on of the Europe an Federati on of Ne urological Soci eti es (EFNS) guidelines and it is assembled with current findings and notati ons particular to Czech specifics. Evidence from original rese arch reports, meta analyses and systematic revi ews published before Janu ary 2007 were considered in the writing of these guidelines.

Results:
The aim in the writing of this guideline was to propose a recommended di agnostic algorithm for Alzheimer’s dise ase, vascular dementi a, frontotemporal dementi a, Parkinson’s dise ase with dementi a, and dementi a with Lewy bodi es. It also contains informati on abo ut clinical di agnostics, blo od tests, ne uro imaging, analysis of the cerebrospinal fluid, genetic tests, bi opsy, informing of di agnosis and monitoring of the behavi oral and psychological symptoms in dementi a.

Conclusi on:
This guideline may contribute to the rati onal di agnostic methods used in the most common dementi a disorders according to evidence‑based medicine.

Key words:
dementi a – Alzheimer’s dise ase – vascular dementi a – di agnostics – guidelines

Sources

1. Waldemar G, Dubo is B, Emre M, Georges J, McKeith IG, Rossor M et al. Recommendati ons for the di agnosis and management of Alzheimer‘s dise ase and other disorders associ ated with dementi a: EFNS guideline. Eur J Ne urol 2007; 14(1): 11– 26.

2. American Psychi atric Associ ati on (APA). Di agnostic and Statistical Manu al of Mental Disorders. DSM- IV, 4th editi on. Washington, D.C.: American Psychi atric Associ ati on 1993.

3. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical di agnosis of Alzheimer‘s dise ase: Report of the NINCDSADRDA Work Gro up under the a uspices of Department of He alth and Human Services Task Force on Alzheimer‘s Dise ase. Ne urology 1984; 34(7): 939– 944.

4. Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey- Blo om J, Relkin N et al. Practice parameter: Di agnosis of dementi a (an evidencebased revi ew). Report of the Qu ality Standards Subcommittee of the American Academy of Ne urology. Ne urology 2001; 56(9): 1143– 1153.

5. Dubo is B, Feldman HH, Jacova C, Dekosky ST, Barberger-Gate a u B, Cummings J et al. Rese arch criteri a for the di agnosis of Alzheimer‘s dise ase: revising the NINCDS– ADRDA criteri a. Lancet Ne urol 2007; 6(8): 734– 746.

6. McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA et al. Consensus guidelines for the clinical and pathological di agnosis of dementi a with Lewy bodi es (DLB): Report of the consorti um on DLB internati onal workshop. Ne urology 1996; 47(5): 1113– 1124.

7. McKeith IG, Dickson DW, Lowe J, Emre M, O‘Bri en JT, Feldman H et al. Di agnosis and management of dementi a with Lewy bodi es: third report of the DLB Consorti um. Ne urology 2005; 65(12): 1863– 1872.

8. Ne ary D, Snowden JS, Gustafson L, Passant U, Stuss D, Black S et al. Frontotemporal lobar degenerati on: a consensus on clinical di agnostic criteri a. Ne urology 1998; 51(6): 1546– 1554.

9. McKhann GM, Albert MS, Grossman M, Miller B, Dickson D, Trojanowski, JQ. Clinical and Pathological Di agnosis of Frontotemporal Dementi a: Report of the Work Gro up on Frontotemporal Dementi a and Pick‘s Dise ase. Arch Ne urol 2001; 58(11): 1803– 1809.

10. Rektorová I. Frontotemporální lobární degenerace – di agnóza z ne uro- psychi atrického pomezí. Ne urol pro praxi 2006; 4: 199– 202.

11. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masde u JC, Garci a JH et al. Vascular dementi a: di agnostic criteri a for rese arch studi es. Report of the NINDS- AIREN Internati onal Workshop. Ne urology 1993; 43(2): 250– 260.

12. Holmes C, Cairns N, Lantos P, Mann A. Validity of current clinical criteri a for Alzheimer‘s dise ase, vascular dementi a and dementi a with Lewy bodi es. Br J Psychi atry 1999; 174: 45– 50.

13. Jorm AF, Jacomb PA. The Informant Questi onnaire on Cognitive Decline in the Elderly (IQCODE): soci odemographic correlates, reli ability, validity and some norms. Psychol Med 1989; 19(4): 1015– 1022.

14. Fuh JL, Teng EL, Lin KN, Larson EB, Wang SJ, Li u CY. The Informant Questi onnaire on Cognitive Decline in the Elderly (IQCODE) as a screening to ol for dementi a for a predominantly illiterate Chinese populati on. Ne urology 1995; 45(1): 92– 96.

15. Lam LC, Chi u HF, Li SW, Chan WF, Chan KY, Wong M. Screening for dementi a: a preliminary study on the validity of the Chinese versi on of the Blessed- Roth Dementi a Scale. Int Psychogeri atr 1997; 9(1): 39– 46.

16. Mackinnon A, Mulligan R. Combining cognitive testing and informant report to incre ase accuracy in screening for dementi a. Am J Psychi atry 1998; 155(11): 1529– 1535.

17. Mackinnon A, Khalili an A, Jorm AF, Korten AE, Christensen H, Mulligan R. Improving screening accuracy for dementi a in a community sample by a ugmenting cognitive testing with informant report. J Clin Epidemi ol 2003; 56(4): 358– 366.

18. Jorm AF. Methods of screening for dementi a: a meta‑analysis of studi es comparing an informant questi onnaire with a bri ef cognitive test. Alzheimer Dis Assoc Disord 1997; 11(3): 158– 162.

19. Folstein MF, Folstein SE, McHugh PR. ”Mini-Mental State“. A practical method for grading the cognitive state of pati ents for the clinici an. J Psych Res 1975; 12(3): 189– 198.

20. Juva K, Sulkava R, Erkinjutti K, Ylikoski R, Valvanne J, Tilvis R. Usefulness of the clinical Dementi a Rating scale in screening for dementi a. Int Psychogeri atr 1995; 7(1): 17– 24.

21. Solomon PR, Hirschoff A, Kelly B, Relin M, Brush M, DeVe a ux RD et al. A 7 minute ne urocognitive screening battery highly sensitive to Alzheimer‘s dise ase. Arch Ne urol 1998; 55(3): 349– 355.

22. Mattis S. Mental status examinati on for organic mental syndrome in the elderly pati ent. In: Bellack L, Karusu TB (eds) Geri atric Psychi atry: a Handbo ok for Psychi atrist and Primary Care Physici ans. New York: Grune & Stratton 1976: 79– 121.

23. Hodges JR, Patterson K, Oxbury S, Funnell E. Semantic dementi a. Progressive fluent aphasi a with temporal lobe atrophy. Brain 1992; 115(6): 1783– 1806.

24. Nelson HE. Modifi ed card sorting test sensitive to frontal lobe defects. Cortex 1976; 12(4): 313– 324.

25. Reitan RM. Validity of the Trail Making Test as an indicati on of organic brain damage. Percept Mot Skills 1958; 8: 271– 276.

26. Stro op JR. Studi es of interference in seri al verbal re acti ons. J Exp Psychol 1935; 28: 643– 662.

27. Benton AL. Differenti al behavi oral effects in frontal lobe dise ase. Ne uropsychologi a 1968; 6: 53– 60.

28. Boze at S, Gregory CA, Ralph MA, Hodges JR. Which ne uropsychi atric and behavi o ural fe atures distinguish frontal and temporal vari ants of frontotemporal dementi a from Alzheimer‘s dise ase? J Ne urol Ne urosurg Psychi atry 2000; 69(2): 178– 186.

29. Pillon B, Dubo is B, Agid Y. Testing cogniti on may contribute to the di agnosis of movement disorders. Ne urology 1996; 46(2): 329– 333.

30. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Ne uropsychi atric Inventory: comprehensive assessment of psychopathology in dementi a. Ne urology 1994; 44(12): 2308– 2314.

31. McKeith IG, Cummings J. Behavi o ural changes and psychological symptoms in dementi a disorders. Lancet Ne urol 2005; 4(11): 735– 742.

32. Finkel S, Burns A. Introducti on. In: Ames D, O’Bri en J (eds). Behavi oral and Psychological Symptoms of Dementi a (BPSD): A Clinical and Rese arch Update. Int Psychogeri at 2000; 12(Suppl 13): 9– 12.

33. Ne ary D, Snowden JS. Clinical fe atures of frontotemporal dementi a. In: Pasqui er F, Lebert F, Scheltens P (eds) Frontotemporal Dementi a Current Issues in Ne urodegenerati on Vol 8. Dordrecht: ICG Publicati ons 1996: 31– 47.

34. Gustavson AR, Cummings JL. Assessment and Tre atment of Ne uropsychi atric Symptoms in Alzheimer‘s dise ase. In: Richter RW, Richter ZR (eds). Alzheimer‘s Dise ase. A Physici an’s Guide to Practical Management. New Jersey: Humana Press 2004: 371– 385.

35. Reisberg B, Borenstein J, Salob SP, Ferris SH, Franssen E, Georgotas A. Behavi oral symptoms in Alzheimer‘s dise ase: phenomenology and tre atment. J Clin Psychi atry 1987; 48(Suppl): 9– 15.

36. Mega MS, Cummings JL, Fi orello T, Gornbein J. The spectrum of behavi oral changes in Alzheimer‘s dise ase. Ne urology 1996; 46(1): 130– 135.

37. Boeve, B, Silber, M, Ferman, T. Associ ati on of REM sleep behavi or disorder and ne urodegenerative dise ase may reflect an underlying synucleinopathy. Mov Disord 2001; 16(4): 622– 630.

38. Doraiswamy PM, Leon J, Cummings JL, Martin D, Ne umann PJ. Prevalence and impact of medical comorbidity in Alzheimer‘s dise ase. J Gerongol A Bi ol Sci Med Sci 2002; 57(3): 173– 177.

39. Fu C, Chute DJ, Farag ES, Garaki an J, Cummings JL, Vinters HV. Comorbidity in dementi a: an a utopsy study. Arch Pathol Lab Med 2004; 128(1): 32– 38.

40. Ott A, Breteler MM, van Harskamp F. Prevalence of Alzheimer‘s dise ase and vascular dementi a: associ ati on with educati on. The Rotterdam study. BMJ 1995; 310(6985): 970– 973.

41. Clarfi eld AM. The decre asing prevalence of reversible dementi as: an updated meta‑analysis. Arch Int Med 2003; 163(18): 2219– 2229.

42. Hejl A, Høgh P, Waldemar G. Potenti ally reversible conditi ons in 1000 consecutive memory clinic pati ents. J Ne urol Ne urosurg Psychi atry 2002; 73(4): 390– 394.

43. DeCarli C, Murphy DG, McIntosh AR, Teichberg D, Schapiro MB, Horwitz B. Discriminant analysis of MRI me asures as a method to determine the presence of dementi a of the Alzheimer type. Psychi atry Res 1995; 57(2): 119– 130.

44. Jack CR jr, Petersen RC, O‘Bri en PC, Tangalos EG. MRbased hippocampal volumetry in the di agnosis of Alzheimer‘s dise ase. Ne urology 1992; 42(1): 183– 188.

45. Killi any RJ, Moss MB, Albert MS, Sandor T, Ti eman J, Jolesz F. Temporal lobe regi ons on magnetic resonance imaging identify pati ents with e arly Alzheimer‘s dise ase. Arch Ne urol 1993; 50(9): 949– 954.

46. de Leon MJ, George AE, Stylopo ulos LA, Smith G, Miller DC. Early marker for Alzheimer‘s dise ase: the atrophic hippocampus. Lancet 1989; 2(8664): 672– 673.

47. de Leon MJ, Convit A, DeSanti S, Bobinski M, George AE, Wisni ewski HM et al. Contributi on of structural ne uro imaging to the e arly di agnosis of Alzheimer‘s dise ase. Int Psychogeri at 1997; 9(Suppl 1): 183– 190.

48. Scheltens P, Fox N, Barkhof F, De Carli C. Structural magnetic resonance imaging in the practical assessment of dementi a: beyond exclusi on. Lancet Ne urol 2002; 1(1): 13– 21.

49. Chetelat G, Baron JC. Early di agnosis of Alzheimer‘s dise ase: contributi on of structural ne uro imaging. Ne uro image 2003; 18(2): 525– 541.

50. Galton CJ, GomezAnson B, Anto un N, Scheltens P, Patterson K, Graves M et al. Temporal lobe rating scale: applicati on to Alzheimer‘s dise ase and frontotemporal dementi a. J Ne urol Ne urosurg Psychi atry 2001; 70(2): 165– 173.

51. Boccardi M, Laakso MP, Bresci ani L, Galluzzi S, Geroldi C, Beltramello A et al. The MRI pattern of frontal and temporal brain atrophy in frontotemporal dementi a. Ne urobi ol Aging 2003; 24(1): 95– 103.

52. Chan D, Fox NC, Jenkins R, Scahill RI, Crum WR, Rossor MN. Rates of global and regi onal cerebral atrophy in AD and frontotemporal dementi a. Ne urology 2001; 57(10): 1756– 1763.

53. Varma AR, Adams W, Lloyd JJ, Carson KJ, Snowden JS, Testa HJ et al. Di agnostic patterns of regi onal atrophy on MRI and regi onal cerebral blo od flow change on SPECT in yo ung onset pati ents with Alzheimer‘s dise ase, frontotemporal dementi a and vascular dementi a. Acta Ne urol Scand 2002; 105(4): 261– 269.

54. van Straaten EC, Scheltens P, Knol DL, van Buchem MA, van Dijk EJ, Hofman PAM et al. Operati onal definiti ons for the NINDSAIREN criteri a for vascular dementi a: an interobserver study. Stroke 2003; 34(8): 1907– 1912.

55. Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesberry WR. Brain infarcti on and the clinical expressi on of Alzheimer dise ase. JAMA 1997; 277(10): 813– 817.

56. Schroter A, Zerr I, Henkel K, Tschampa HJ, Finkenstaedt M, Poser S. Magnetic Resonance Imaging in the clinical di agnosis of Cre utzfeldt-Jakob dise ase. Arch Ne urol 2000; 57(12): 1751– 1757.

57. Barber R, Gholkar A, Scheltens P, Ballard C, McKeith IG, O‘Bri en JT. Medi al temporal lobe atrophy on MRI in dementi a with Lewy bodi es. Ne urology 1999; 52(6): 1153– 1158.

58. Do ugall NJ, Bruggink S, Ebmei er KP. Systematic revi ew of the di agnostic accuracy of 99mTcHMPAOSPECT in dementi a. Am J Geri atr Psychi atry 2004; 12(6): 554– 570.

59. Patwardhan MB, McCrory DC, Marchar DB, Sams GP, Rutschmann OT. Alzheimer Dise ase: Operating Characteristics of PET: a metaanalysis. Radi ology 2004; 231(1): 73– 80.

60. O‘Bri en JT, Colloby S, Burn D, Willi ams ED, Firbanks M, Aarsland D et al. Dopamine transporter loss visu alized with FP- CIT SPECT in the differenti al di agnosis of dementi a with Lewy bodi es. Arch Ne urol 2004; 61(6): 919– 925.

61. Walker Z, Costa DC, Walker RW, Shaw K, Gacinovic S, Stevens T et al. Differenti ati on of dementi a with Lewy bodi es from Alzheimer‘s dise ase using a dopaminergic presynaptic ligand. J Ne urol Ne urosurg Psychi atry 2002; 73(2): 134– 140.

62. Tolosa E, Wenning G, Poewe W. The di agnosis of Parkinson’s dise ase. Lancet Ne urol 2006; 5(1): 75– 86.

63. McKeith IG, Dickson DW, Lowe J, Emre M, O‘Bri en JT, Feldman H et al. Dementi a with Lewy Bodi es: Di agnosis and Management: Third Report of the DLB Consorti um. Ne urology 2005; 65(12): 1863– 1872.

64. Zerr I, Pocchi ari M, Collins S, Brandel JT, de Pedro Cuesta J, Knight RS et al. Analysis of EEG and CSF 1433 proteins as aids to the di agnosis of Cre utzfeldt-Jakob dise ase. Ne urology 2000; 55(6): 811– 815.

65. Steinhoff BJ, Racker S, Herrendorf G, Poser S, Grosche S, Zerr I et al. Accuracy and reli ability of peri odic sharp wave complexes in Cre utzfeldt-Jakob dise ase. Arch Ne urol 1996; 53(2): 162– 166.

66. Zeman AZ, Boniface SJ, Hodges JR. Transi ent epileptic amnesi a: a descripti on of the clinical and ne uropsychological fe atures in 10 cases and a revi ew of the literature. J Ne urol Ne urosurg Psychi atry 1998; 64(4): 435– 443.

67. Høgh P, Smith SJ, Scahill RI, Chan D, Harvey RJ, Fox NC et al. Epilepsy presenting as AD: ne uro imaging, electroclinical fe atures, and response to tre atment. Ne urology 2002; 58(2): 298– 301.

68. Verbeek MM, De Jong D, Kremer HPH. Brain-specific proteins in cerebrospinal fluid for the di agnosis of ne urodegenerative dise ases. Ann Clin Bi ochem 2003; 40(1): 25– 40.

69. Hort J, Glosová L, Vyhnálek M, Bojar M, Škoda D, Hladíková M. Ta u protein a beta amylo id v likvoru u Alzheimerovy choroby. Cesk Slov Ne urol N 2007; 70(1): 30– 36.

70. Lemstra AW, van Meegen M, Baas F, van Go ol WA. Clinical algorithm for cerebrospinal fluid test of 1433 protein in di agnosis of Cre utzfeldt-Jacob dise ase. Ned Tijdschr Geneeskd 2001; 145(30): 1467– 1471.

71. Harper PS, Morris MJ, Tyler A. Genetic testing for Huntington’s dise ase. BMJ 1990; 300(6732): 1089– 1090.

72. Alzheimer Europe. Recommendati ons on how to improve the legal rights and protecti on of adults with incapacity due to dementi a. [online]. Last revisi on 24th Febru ary 2006. Dostupné z: <http:/ / www.alzheimer- e urope.org>.

73. Fe arnley K, McLennan J, We aks D. The right to know – Sharing the di agnosis of dementi a. Edinburgh: Alzheimer Scotland – Acti on on dementi a 1999.

74. She ardová K, Hort J, Rusina R, Bartoš A, Línek V, Ressner P, Rektorová I. Doporučené postupy pro léčbu Alzheimerovy nemoci a dalších onemocnění spojených s demencí. Cesk Slov Ne urol N 2007; 70/ 103(5): 589– 594.