Clinicopathological analysis of dementia disorders in the elderly

Jellinger, K. A.; Danielczyk, W; Fischer, Peter; Gabriel, Edmo Atique

doi:10.1016/0022-510x(90)90072-u

Cited by 216 publications

(104 citation statements)

References 39 publications

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“…The sensitivity of the clinical diagnosis for DAT was 75.9 % and the specificity 60.6 %. Thus, the present results are similar to those reported in previous studies (2)(3)(4)(5). Older patients more commonly suffered from multiple etiologies of dementia than younger patients.…”

Section: Resultssupporting

confidence: 82%

“…the number of patients having clinical and neuropathological diagnosis other than diagnosis A divided by the total number of patients with a neuropathological diagnosis other than diagnosis A. The sensitivity and specificity of the clinical diagnosis of DAT in the present sample were 75.9 % and 60.6 %, respectively, and are similar to those reported in previous studies (2)(3)(4)(5).…”

Section: Sensitivity and Specificity Of The Clinical Diagnosis Of Datsupporting

confidence: 79%

“…However, the clinical diagnosis remains an estimation of the underlying neuropathology until the definitive diagnosis is established upon autopsy. Studies investigating the diagnostic accuracy for dementia have reported rates between 52 and 100 % for DAT (2)(3)(4)(23)(24)(25)(26) and between 21 and 95 % for VaD (2-4, 23, 25-27). However, these studies included younger patients with few comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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The validity of clinical diagnoses of dementia in a group of consecutively autopsied memory clinic patients

Taylor

Hohl

Tolnay

et al. 2008

The Journal of nutrition, health and aging

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Abstract:Background: Epidemiological studies show that up to 10 % of individuals aged 65 years and older suffer from dementia, most commonly from dementia of the Alzheimer Type (DAT) [1]. Clinicopathological studies are critical to our understanding of this disease and improving the accuracy of clinical diagnoses. Objectives: Our objectives were to examine the validity of clinical diagnoses of DAT, to determine the prevalence of different forms of dementia in this sample, and to investigate the relationship between age at death and polymorbidity. Subjects and method: Clinical data were available from 221 patients who had been examined at the Basel Memory Clinic between 1986 and 1996. From this population, 34 % (75 patients) were autopsied in the Department of Pathology, University Hospital Basel, and neuropathological examinations were additionally performed on 62 (83 %) of these patients. Clinical and neuropathological data were retrospectively compared. Results: 67.8 % of the neuropathologically examined patients received a definitive diagnosis of AD (Alzheimer's disease), vascular dementia (VaD) or mixed dementia (AD and VaD). AD alone or with other histopathological hallmarks of dementia was the most prevalent neuropathological diagnosis (63 %). VaD was deemed the only cause of dementia in only 4.8 % of patients. The sensitivity for DAT was 75.9 %, the specificity 60.6 %. Increasing age was associated with an increasing number of clinical and neuropathological diagnoses. Conclusion:The sensitivity and specificity of the clinical diagnoses of DAT found in our study are similar to previous reports (2-5). Older patients had more etiologies of their dementia than younger patients. This study reaffirms the need for internationally accepted criteria for clinical and neuropathological diagnoses, as well as further clinical-neuropathological investigations to further refine the clinical diagnostic process.

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Section: Resultssupporting

confidence: 82%

Section: Sensitivity and Specificity Of The Clinical Diagnosis Of Datsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

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The validity of clinical diagnoses of dementia in a group of consecutively autopsied memory clinic patients

Taylor

Hohl

Tolnay

et al. 2008

The Journal of nutrition, health and aging

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“…This may suggest a shared pathogenic relationship and unifying explanation. Alzheimer's disease patients also have some degree of vascular changes and one-fifth have vascular lesions (Jellinger et al, 1990), which probably contributes to their cognitive decline. The link between stroke and Alzheimer 's disease seems to be higher than that expected by chance and may reduce the period of preclinical Alzheimer's disease.…”

Section: Genetic Factorsmentioning

confidence: 99%

Risk factors for dementia

McCullagh¹,

Craig²,

McIlroy³

et al. 2001

Adv. psychiatr. treat

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There is little doubt that dementia is a very common cause of disability and dependency in our society. Since dementia of whatever type is usually more common with increasing age, then as population demographics change, so will the prevalence of dementia. Dementia is a generic term and the objective for clinicians, once dementia is suspected, is to attempt to define the cause. Alzheimer's disease is the most common cause of dementia, and in most centres vascular dementia would feature as the next most common aetiology. In some centres, Lewy body dementia is the second most common cause. Mixed Alzheimer's disease and vascular dementia would also feature high on the list at most centres.

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“…For instance, postmortem studies have shown that, with an increase in age, vascular pathologies become the main pathological findings in the brain of subjects with dementia, whereas cognitive impairment in younger subjects is more related to typical neuropathologic changes commonly observed in Alzheimer disease. 32,33 In other words, cognitive impairment in old age might be a better reflection of brain vascular pathologies, which predispose subjects to future cerebrovascular events. Another explanation could be that patients with cognitive impairment might have a worse medical adherence or they receive less aggressive treatments compared with cognitively healthy people.…”

mentioning

confidence: 99%

Cognitive Impairment and Risk of Stroke

Rostamian

Mahinrad

Stijnen³

et al. 2014

Stroke

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PubMed, EMBASE, and Web of Science were searched with the terms cognitive function, cognition disorders, cognitive test, stroke, cerebrovascular disorders, and cerebrovascular accidents ( Figure I in the online-only Data Supplement). The design of electronic search strategy was done in consultation with an expert reference librarian, and the period of search was from January 1, 1980, to October 1, 2013, without language restrictions. We used broad inclusion criteria for search strategy, including all types of stroke and cognitive impairment assessed by various cognitive tests and measurements. Eligibility Criteria/Study SelectionExtracted citations were screened for eligibility by 2 independent reviewers (S.R. and S.M.). Studies were included if they met the following criteria: (1) prospective study design, (2) assessment of cognitive impairment preceding stroke, (3) outcome of interest was stroke, and (4) estimated risk of stroke by valid statistical analysis. The Background and Purpose-Cognitive impairment is linked to vascular risk factors and brain vascular pathologies. Several studies have tested whether subjects with cognitive impairment have higher risk for stroke. The aim of this study was to systematically review available evidence on the association between cognitive impairment and risk of stroke to obtain precise effect estimates of the association and to identify which cognitive domains associate most with incident stroke. Methods-PubMed, EMBASE, and Web of Science were searched from January 1, 1980, to October 1, 2013, without language restriction. Only prospective cohort studies were included. From each study, data on the association between cognitive impairment and stroke estimated with hazard ratios or relative risks with 95% confidence interval (CI) were extracted. For each study, risk of stroke per SD lower performance in various cognitive tests was calculated. Results-Twelve studies were included, comprising 82 899 participants of whom 3043 had an incident stroke. The pooled relative risk per SD lower global cognitive performance was 1.19 (95% CI, 1.12-1.27). Each SD lower score in executive function or attention was associated with 1.14-fold (95% CI, 1.06-1.24) higher risk of stroke. Lower scores in memory were associated with 1.07-fold (95% CI, 1.02-1.12) higher risk of stroke, and lower scores in language were associated with 1.08-fold (95% CI, 1.02-1.16) higher risk of stroke. Correspondence to Behnam Sabayan, MD, MSc, Department of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands. E-mail b.sabayan@lumc.nl © 2014 American Heart Association, Inc. Conclusions-Cognitive Rostamian et al Cognitive Impairment and Stroke 1343reviewers independently screened titles and abstracts to determine possible eligibility for inclusion (exclusion and inclusion criteria are presented in Table I in the online-only Data Supplement). Differences of opinion between the 2 reviewers were resolved by discussion with the third reviewer (B.S.). Then, full art...

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Clinicopathological analysis of dementia disorders in the elderly

Cited by 216 publications

References 39 publications

The validity of clinical diagnoses of dementia in a group of consecutively autopsied memory clinic patients

The validity of clinical diagnoses of dementia in a group of consecutively autopsied memory clinic patients

Risk factors for dementia

Cognitive Impairment and Risk of Stroke

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