Wisniewski H M, Silverman W
New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314, USA.
Neurobiol Aging. 1997 Jul-Aug;18(4 Suppl):S43-50. doi: 10.1016/s0197-4580(97)00068-7.
A Consensus Conference focusing on Alzheimer's disease (AD) took place in November 1996 to recommend uniform evaluation procedures and diagnostic criteria, co-sponsored by the National Institute on Aging and the Reagan Institute of the Alzheimer's Association. In conjunction with this conference, we reviewed diagnostic practices in current use, together with various neuropathological criteria proposed since 1985. Difficulties were identified in developing "gold standard" criteria for diagnosis and case classification of AD based upon the current state of knowledge. Working criteria for use within research contexts were proposed that acknowledged the realities of scientific limitations by inclusion of a broad and heterogeneous category of "uncertain" cases. (Eventually, methods will be developed for identifying these cases as preclinical AD, dementia due to multiple causes or non-AD, but this is not now possible.) Within applied contexts, the use of CERAD guidelines was supported. Finally, recommendations generated at the Consensus Conference were discussed, emphasizing the rapid pace of recent scientific advancement and the need for ongoing empirical reevaluation and modification of the Group's proposal.
1996年11月召开了一次聚焦阿尔茨海默病（AD）的共识会议，以推荐统一的评估程序和诊断标准，该会议由美国国立衰老研究所和阿尔茨海默病协会里根研究所共同主办。在此次会议期间，我们回顾了当前使用的诊断方法，以及自1985年以来提出的各种神经病理学标准。基于当前的知识水平，在制定AD诊断和病例分类的“金标准”标准时发现了困难。提出了在研究背景下使用的工作标准，通过纳入广泛且异质性的“不确定”病例类别来承认科学局限性的现实情况。（最终，将开发出方法来将这些病例识别为临床前AD、多种原因导致的痴呆或非AD，但目前还无法做到。）在应用背景下，支持使用CERAD指南。最后，讨论了共识会议产生的建议，强调了近期科学进步的快速步伐以及对该小组提议进行持续实证重新评估和修改的必要性。
