Table 3

Summary of CERAD26 and NIA–Reagan Institute pathological criteria for Alzheimer’s disease27

CERAD criteriaNIA–Reagan Institute criteria
CERAD, consortium to establish a registry of Alzheimer’s disease; NFT, neurofibrillary tangle; NIA, National Institute on Aging.
MethodSemiquantitative assessment of neuritic plaque density, graded by “cartoon” comparison as sparse, moderate, and frequentAll lesions considered (amyloid deposits, neuritic plaques, neuropil threads and NFT)
Sampling of multiple cortical areas and midbrain“Age-related plaque score” and topographic staging of NFT combined with clinical information
Generation of “age related plaque score”Probabilistic approach for diagnosis of dementia
Categories0No evidence of Alzheimer’s disease
AUncertain evidence of Alzheimer’s diseaseLow probability: CERAD “sparse” and Braak stage I/II
BSuggestive of Alzheimer’s diseaseIntermediate probability: CERAD
CIndicative of Alzheimer’s disease“Moderate” and Braak stage III/IV high probability: CERAD “frequent” and Braak stage V/VI
Potential disadvantagesNeurites in plaques do not have to display tau immunoreactivityOther possible combinations of CERAD and Braak scores not considered. Uncertainty over application when no clinical details