To assess prospectively the accuracy of standard antemortem clinical
diagnostic criteria for Alzheimer's disease, post-mortem examinations were
performed on 25 patients who had met DSM-III criteria for primary
degenerative dementia and National Institute of Neurological and
Communicative Disorders and Stroke criteria for probable Alzheimer's
disease. Seventeen patients (68%) met neuropathological criteria for
Alzheimer's disease. Two presenile-onset patients had diffuse neocortical
senile plaques of insufficient number for definite Alzheimer's disease. Six
patients had non-Alzheimer's disease diagnoses. Five of these six had
presenile-onset dementia. These results suggest caution in the antemortem
diagnosis of Alzheimer's disease in presenile-onset dementia.
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