Psychotic Alzheimer’s Patients More Likely To Be Misdiagnosed, Study Finds

Psychotic Alzheimer’s Patients More Likely To Be Misdiagnosed, Study Finds
Doctors tend to miss Alzheimer's diagnosis in psychotic patients more likely than than non-psychotic ones, according to new research by Canada's University of Toronto. The study, “Determining the impact of psychosis on rates of false-positive and false-negative diagnosis in Alzheimer's disease,” appeared in the journal Alzheimer’s & Dementia: Translation Research and Clinical Intervention. Alzheimer's is frequently misdiagnosed. Patients can often have a false-positive, meaning doctors diagnose them with Alzheimer's even they don't actually have the disease. On the other hand, Alzeimer's is often missed in patients — a false-negative — because the pathology resembles other types of dementia such as frontotemporal dementia (FTD) and dementia with Lewy bodies (DLB). Many studies have shown that the only way to correctly diagnose Alzheimer's is by using an autopsy-based neuropathologic diagnosis rather than clinical criteria. Current estimates of the true positive rate (sensitivity) is 71 to 87 percent, while the true negative rate (specificity) is 44 to 71 percent. Psychosis often develops due to brain pathology in neurodegenerative diseases. It can also affect diagnosis rates in Alzheimer's patients, the actual impact is unclear. Given that a misdiagnosis of Alzheimer's can have significant implications for clinical care, Canadian researchers set out to determine the rates of misdiagnosis in Alzheimer's patients with and without psychotic features, using data from the Seattle-based National Alzheimer's Coordinating Center (NACC) database. They found that 76 percent o
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