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Very mild Alzheimer's disease: informant-based clinical, psychometric, and pathologic distinction from normal aging
Morris JC, McKeel DW, Storandt M, Rubin EH, Price JL, Grant EA, Ball MJ, Berg L.. Neurology, 1991-04-01
Topic: Amyloid, tau and blood-test diagnosis
We compare clinicopathologic data from 10 subjects identified in the very mild stage of senile dementia of the Alzheimer type with findings from similar studies in four cognitively normal subjects. We based the diagnosis of very mild dementia in the 10 subjects on informant reports and the judgment of experienced clinicians. Deficits of some psychometric measures of memory, language, and speeded psychomotor performance were observed for these subjects. The histologic markers of Alzheimer's disease, including neurofibrillary tangles and both the "diffuse" and classic subtypes of senile plaques, were present in the neocortex in all 10 subjects but essentially were absent in the four controls. These findings indicate that even "questionable" dementia can be diagnostic for Alzheimer's disease. Furthermore, because truly normal aging may be unaccompanied by neocortical senile plaques and neurofibrillary tangles, the presence of these lesions should suggest the possibility of clinically undetected Alzheimer's disease.
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APA 7th
Morris, J. C., McKeel, D. W., Storandt, M., Rubin, E. H., Price, J. L., Grant, E. A., et al. (1991). Very mild Alzheimer's disease: informant-based clinical, psychometric, and pathologic distinction from normal aging. Neurology. https://doi.org/10.1212/wnl.41.4.469
Vancouver
Morris JC, McKeel DW, Storandt M, Rubin EH, Price JL, Grant EA, et al. Very mild Alzheimer's disease: informant-based clinical, psychometric, and pathologic distinction from normal aging. Neurology. 1991. doi:10.1212/wnl.41.4.469. PMID: 2011242.
BibTeX
@article{morris1991-2011242,
author = {Morris, J. C. and McKeel, D. W. and Storandt, M. and Rubin, E. H. and Price, J. L. and Grant, E. A. and Ball, M. J. and Berg, L.},
title = {{Very mild Alzheimer's disease: informant-based clinical, psychometric, and pathologic distinction from normal aging}},
journal = {Neurology},
year = {1991},
doi = {10.1212/wnl.41.4.469},
pmid = {2011242},
url = {https://doi.org/10.1212/wnl.41.4.469}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- These findings indicate that even "questionable" dementia can be diagnostic for Alzheimer's disease.
Why it matters
In 10 people identified in the very mild stage of Alzheimer-type dementia, memory, language, and speeded psychomotor deficits were found, and plaques and tangles were present in the neocortex in all 10 but essentially absent in four cognitively normal controls. The authors conclude that even questionable dementia can be diagnostic for Alzheimer's disease and that these lesions should suggest clinically undetected disease, but no treatment, cure, or prevention was tested.
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Study details
- Evidence strengthLow
How this study scored 50/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 48 of the 96 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1991 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 475 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.8 citations a year over 37 year(s) since 1991 |
| Impact for its field and year | 5 / 6 | Cited 23.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 27 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author L Berg holds only 9 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 2011242) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 48 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 48 of the 96 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
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