Evaluating combinations of diagnostic tests to discriminate different dementia types

Marie Bruun (Corresponding Author), Hanneke F.M. Rhodius-Meester, Juha Koikkalainen, Marta Baroni, Le Gjerum, Afina W. Lemstra, Frederik Barkhof, Anne M. Remes, Timo Urhemaa, Antti Tolonen, Daniel Rueckert, Mark van Gils, Kristian S. Frederiksen, Gunhild Waldemar, Philip Scheltens, Patrizia Mecocci, Hilkka Soininen, Jyrki Lötjönen, Steen G. Hasselbalch, Wiesje M. van der Flier

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Introduction: We studied, using a data-driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia. Methods: In this multicenter study, we included 356 patients with Alzheimer's disease, 87 frontotemporal dementia, 61 dementia with Lewy bodies, 38 vascular dementia, and 302 controls. We used a classifier to assess accuracy for individual performance and combinations of cognitive tests, cerebrospinal fluid biomarkers, and automated magnetic resonance imaging features for pairwise differentiation between dementia types. Results: Cognitive tests had good performance in separating any type of dementia from controls. Cerebrospinal fluid optimally contributed to identifying Alzheimer's disease, whereas magnetic resonance imaging features aided in separating vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Combining diagnostic tests increased the accuracy, with balanced accuracies ranging from 78% to 97%. Discussion: Different diagnostic tests have their distinct roles in differential diagnostics of dementias. Our results indicate that combining different diagnostic tests may increase the accuracy further.

Original languageEnglish
Pages (from-to)509-518
Number of pages10
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Publication statusPublished - 1 Jan 2018
MoE publication typeNot Eligible


  • Alzheimer's disease
  • Biomarkers
  • Clinical decision support system
  • CSF
  • Dementia with Lewy bodies
  • Diagnostic test assessment
  • Differential diagnosis
  • Frontotemporal dementia
  • MRI
  • Vascular dementia

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    Bruun, M., Rhodius-Meester, H. F. M., Koikkalainen, J., Baroni, M., Gjerum, L., Lemstra, A. W., Barkhof, F., Remes, A. M., Urhemaa, T., Tolonen, A., Rueckert, D., van Gils, M., Frederiksen, K. S., Waldemar, G., Scheltens, P., Mecocci, P., Soininen, H., Lötjönen, J., Hasselbalch, S. G., & van der Flier, W. M. (2018). Evaluating combinations of diagnostic tests to discriminate different dementia types. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 10, 509-518. https://doi.org/10.1016/j.dadm.2018.07.003