This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The current diagnosis of Alzheimer's disease is one of comprehensive exclusion of other etiologies of dementia combined with identification of characteristic cognitive dysfunction and a typical temporal profile of progression. In particular, the goal is to exclude the systemic or the many degenerative and the few stable neurological disorders that may induce cognitive dysfunction or dementia. A thorough clinical evaluation has been designed to exclude these other illnesses and confirm over time or with the availability of historical data of progression, the presence of AD. This clinical evaluation was initially identified in the Report of the Work Group on AD comprised of members from the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. Subsequent studies have shown that this comprehensive clinical evaluation has sensitivity of the order of 90% and specificity of 90% as later confirmed by autopsy. Additionally, the NINCDS-ADRDA proposed evaluation has a high rate of interobserver reliability. Clinical centers which have enrolled as members of the National Alzheimer's Disease Cooperative Study have reported on accuracy of better than 90%. At present, post-mortem autopsy is the only way to confirm a diagnosis of Alzheimer's disease. These studies will examine the feasibility of using various biochemical assays to aid in the ante-mortem diagnosis of Alzheimer's disease. This will be accomplished ex vivo using blood and urine specimens from patients with a diagnosis of probable Alzheimer's disease or mild cognitive impairment and from normal controls.
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