Detection of alzheimer's disease and dementia in the preclinical phase: Population based cohort study

Katie Palmer, Lars Bäckman, Bengt Winblad, Laura Fratiglioni

Research output: Contribution to journalArticlepeer-review


Objectives To evaluate a simple three step procedure to identify people in the general population who are in the preclinical phase of Alzheimer's disease and dementia. Design Three year population based cohort study. Setting Kungsholmen cohort, Stockholm, Sweden. Participants 1435 people aged 75-95 years without dementia. Assessments Single question asking about memory complaints, assessment by mini-mental state examination, and neuropsychological testing. Main outcome measure Alzheimer's disease and dementia at three year follow up. Results None of the three instruments was sufficiently predictive of Alzheimer's disease and dementia when administered separately. After participants had been screened for memory complaints and global cognitive impairment, specific tests of word recall and verbal fluency had positive predictive values for dementia of 85-100% (95% confidence interval range from 62% to 100%). However, only 18% of furore dementia cases were identified in the preclinical phase by this three step procedure. Memory complaints were the most sensitive indicator of Alzheimer's disease and dementia in the whole population, but only half the future dementia cases reported memory problems three years before diagnosis. Conclusion This three step procedure, which simulates what might occur in clinical practice, has a high positive predictive value for dementia, although only a small number of future cases can be identified.

Original languageEnglish
Pages (from-to)245-247
Number of pages3
JournalBritish Medical Journal
Issue number7383
Publication statusPublished - Feb 1 2003

ASJC Scopus subject areas

  • Medicine(all)


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