NINCDS-ADRDA Criteria for the Diagnosis of Alzheimer’s Disease

 NINCDS-ADRDA Criteria for the Diagnosis of Alzheimer’s Disease

NINCDS-ADRDA Criteria for the Diagnosis of Alzheimer’s Disease


Criteria for the clinical diagnosis of Probable AD

Dementia established by

        Clinical examination,  and

        Documented by the MMSE, BDS, or other similar examination,  and

        Confirmed by neuropsychological test


  Deficits in two or more areas of cognition

  Progressive worsening of memory and other cognitive functions

  No disturbance of consciousness

  Onset between ages 40 and 90, most often after age 65

  Absence of systemic disorders or other brain diseases that could account for the

     progressive deficits in memory and cognition


The diagnosis of probable AD is supported by

  Progressive deterioration of specific cognitive functions such as language   (aphasia), motor skills (apraxia), and perception (agnosia);

  Impaired activities of daily living and altered patterns of behavior

  Family history of similar disorders, particularly if neuropathologically confirmed

 Laboratory results of

        Normal lumbar puncture as evaluated by standard techniques;

      Normal pattern or nonspecific EEG changes, such as increased slowwave


    Evidence of cerebral atrophy on CT with progression documented by serial



Other clinical features consistent with probable ADafter exclusion of other causes of dementia

  Plateaus in the course of progression of the illness

  Associated symptoms of depression, insomnia, incontinence, delusions, illusions,          hallucinations, catastrophic verbal, emotional, or physical outburst, sexual disorders, and weights loss

    Other neurological abnormalities in some patients, especially those with more

      advanced disease, including motor signs such as increased muscle tone,

      myoclonus, or gait disorder

  Seizures in advanced disease

  CT normal for age


Features that make the diagnosis of probable AD uncertain or unlikely

  Sudden, apoplectic onset

  Focal neurologic findings such as hemiparesis, sensory loss, visual field deficits,

        and incoordination early in the course of the illness

  Seizures or gait disturbances at the onset of symptoms or very early in the course

     of the illness




Diagnosis of Possible AD


May be made on the basis of the dementia syndrome;

      In the absence of other neurologic, psychiatric, or systemic disorders

         sufficient to cause dementia; and

      in the presence of variations in the onset, presentation, or clinical course

    May be made in the presence of a second systemic or brain disorder sufficient to

      produce dementia but considered to be the cause of the dementia

    Should be used in research studies when a singlegradually progressivesevere

   cognitive deficit is identified in the absence of another identifiable cause




Criteria for diagnosis of Definite AD


Clinical criteria for probable AD

Histopathologic evidence obtained from biopsy or autopsy

Subtype classification for research purposes

Familial occurrence

Onset before age 65

Presence of trisomy-21

Coexistence of other relevant conditionssuch as PD


                                                  Adapted from NINCDS-ADRDA work group, McKhann et al.; 1984

                                                  AD=Alzheimer’s disease, MMSE=Mini-Mental State Examination

                                                  BDS=Blessed Dementia Scale, PD=Parkinson’s disease.