Appendix e-1. Detailed methods of clinical data collection

Assessment of presenting symptoms

Short-term memory: Consistent short-term memory deficits were diagnosed if the clinician rated

the individual as ≥0.5 in the Clinical Dementia Rating memory domain (clinical decision

integrating informant and individual report, and performance on neurological exam).

Judgment and problem solving: Judgement and problem solving deficits were diagnosed if the

clinician rated the individual as ≥0.5 in the Clinical Dementia Rating judgement and problem

solving domain.

Language: Present if the informant or individual expressed emergent word-finding or expressive

speech difficulties.

Behavioral and/or personality: Present if the informant or individual indicated consistent changes

in behavior and/or personality.

Motor dysfunction: Present if the informant or participant affirmed motor impairment, slowness

of movement, change in gait and/or falls.

Visuospatial difficulties: Present if the informant indicated that the individual “sometimes” or

“rarely” was able to “find his/her way about familiar streets”, or if problems with visuospatial

manipulation was noted.

Assessment of clinical features

Personality and behavioral changes: Present if moderate or severe changes were noted on the

Neuropsychiatric Inventory Questionnaire.

Mood disorder (depression): Present if the clinician indicated that the individual was

“depressed”, or that additional medical attention was required for the evaluation of depressive

mood (based on Geriatric Depression Scale score).

Falls: Present if the informant or individual indicated falls in the preceding one year.

Urinary incontinence: Present if the informant or individual indicated urinary incontinence in the

preceding one year.

Autobiographical memory: Impaired if the summed score of 1-week and 1-month recall of

events was 1.5 or less. The clinician rates the participant’s recall for each of the events as largely

correct (1 point), partially correct (0.5 points), or largely incorrect (0 points). Maximum possible

score: 1.0 + 1.0 = 2.0.

Short-term verbal recall: Impaired if one or more errors were made when recalling the encoded

phrase, “John Brown, 42 Market Street, Chicago”, following a short (2 minute) delay.

Object copy: Impaired if errors were made when copying a triangle, cube, or pentagon.

Assessment of Aphasia: Impaired when the answer to the clinician’s assessment of aphasia was

“present”. The clinical diagnosis of aphasia integrates findings from the clinical examination and

the Boston Diagnostic Aphasia Examination (Third Edition).

Extraocular movement abnormality: Present if impairment in extraocular movements were noted

on neurological examination (i.e., restricted range of motion, hypometric/hypometric saccades).

Asymmetrical features: Present if abnormal motor or sensory cortical findings (i.e., not

indicative of peripheral lesions) were detected on examination of motor and sensory function

(including assessment for graphesthesia and/or stereognosis).

Parkinsonism or dystonia: Present if ≥2 extrapyramidal signs were detected on neurological

examination, including rest tremor, bradykinesia, rigidity and postural instability, or if dystonia

was diagnosed.

Pathological hyperreflexia: Present if brisk (pathologic) reflexes (≥3+) were elicited on

neurological examination.

Limb Apraxia: Present if there was difficulty in demonstration of use of “toothbrush”, “key”

and/or “pencil” during the physical examination (demonstration following verbal command).

Alien Limb Phenomenon: Present when participant described dissociation from one’s own limb

(i.e., inter-manual conflict), and examiner observed asymmetric motor or sensory abnormalities

in corresponding limb. Simple levitation was excluded.

Myoclonus: Present if myoclonus was detected on neurological examination.

Abnormal gait: Present if abnormal gait pattern was detected, and not attributed to

musculoskeletal impairment or injury.