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 slow－wave
activity;
□ Evidence of cerebral atrophy on CT with progression documented by serial observation
Other clinical features consistent with probable AD﹐after 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 single﹐gradually progressive﹐severe 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 conditions﹐such 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.