Dubois et al reported criteria from an international working group (IWG) for the diagnosis of Alzheimer's Disease (AD). Mixed Alzheimer's disease can be diagnosed if certain findings are present. The authors are from multiple institutions in Europe and North America.
Criteria for mixed pathology - both of the following:
(1) clinical and biomarker evidence of Alzheimer's disease
(2) clinical and biomarker evidence of second disorder
Clinical and biomarker evidence of Alzheimer's disease - both of the following:
(1) one of the following:
(1a) amnestic syndrome of the hippocampal type
(1b) one of the clinical phenotypes of atypical Alzheimer's disease
(2) at least one of the following:
(2a) decreased amyloid beta(1-42) with increased T-tau or P-tau in the CSF
(2b) increased tracer retention on amyloid PET
Clinical and biomarker evidence of cerebrovascular disease as second disorder - both of the following:
(1) documented history of stroke OR focal neurological features consistent with stroke
(2) MRI evidence of: corresponding vascular lesions, small vessel disease, strategic lunar infarcts and/or cerebral hemorrhages
Clinical and biomarker evidence of Lewy body disease as second disorder - both of the following:
(1) at least one of the following: extrapyramidal signs, early hallucinations or cognitive fluctuations
(2) abnormal dopamine transporter PET scan
