Reliability and Validity of Nincds-Adrda Criteria for Alzheimer's Disease: The National Institute of Mental Health Genetics Initiative

Deborah Blacker, Marilyn S. Albert, Susan S. Bassett, C. P. Rodney, Lindy E. Harrell, Marshai F. Folstein

Research output: Contribution to journalArticle


To assess interrater reliability and validity of NINCDS-ADRDA (National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association) criteria for Alzheimer's disease (AD). A multisite reliability and validity study in which clinicians from each site diagnosed 60 case summaries yielding a preconsensus estimate of reliability and validity. A consensus conference was conducted for each disagreement, leading to a postconsensus estimate of validity. The criterion standard was a diagnosis of AD by autopsy. Three academic medical centers. A convenience sample of 60 detailed case summaries, 40 with AD and 20 with other dementing disorders. The κ coefficient, sensitivity, and specificity. The κ coefficient for preconsensus agreement on a diagnosis of probable or possible AD vs non-AD was 0.51; the sensitivity of a diagnosis of probable or possible AD for a pathological diagnosis of AD was 0.81, and the specificity was 0.73. The postconsensus sensitivity was 0.83, and the specificity was 0.84. The results support the reliability and validity of NINCDS-ADRDA criteria and show that the consensus process may improve diagnostic accuracy. The cases are reviewed with a focus on the sources of diagnostic disagreements and errors and possible changes that might improve the accuracy of the criteria.

Original languageEnglish (US)
Pages (from-to)1198-1204
Number of pages7
JournalArchives of neurology
Issue number12
StatePublished - Dec 1994
Externally publishedYes


ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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