Comparison of Different Diagnostic Criteria for Vascular Dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN)

Wetterling, Tilman; Kanitz, Rolf-Dieter; Borgis, K. J.

doi:10.1161/01.str.27.1.30

Cited by 232 publications

(147 citation statements)

References 37 publications

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“…The diagnostic accuracy of the ICD-10 criteria is low. [32][33][34] The sensitivity of the ICD-10 criteria, as well as others, is very low. Thus while the clinical criteria used here identified subjects with clinical cerebrovascular syndromes, we do not know the extent of the link between the clinical diagnosis of VaD and cerebrovascular pathology.…”

Section: Discussionmentioning

confidence: 99%

“…Conditional logistic regression represents an extreme form of stratification to control for confounding exposures where each case is matched to specific controls. 33.0 years, SD 7.1). AD cases' parents had been married for a median 3.9 years (interquartile range 1.2-10.5 years) at the case's birth, VaD cases' parents for 5.0 (1.2-10.0) years, and unspecified dementia parents for 3.5 (1.3-9.5) years.…”

Section: Statistical Analysis After Initial Data Description Compari-mentioning

confidence: 96%

See 1 more Smart Citation

Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia

McGurn¹,

Deary²,

Starr³

2008

Neurology

112

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Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysis After Initial Data Description Compari-mentioning

confidence: 96%

Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia

McGurn¹,

Deary²,

Starr³

2008

Neurology

112

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“…The proportion of stroke patients with PSD depends mainly on the age range, length of follow-up, and diagnostic criteria. 9,31,32 Some studies involving PSD have been performed on nonprospective 16,33 or nonconsecutive samples 16,[33][34][35] ; some others have excluded hemorrhagic 6 -8,10,13,16,33,36,37 or recurrent 6,8,16,16 strokes; usually, the cognitive status before the stroke has not been considered. 16,34,38 We recruited a series of consecutive, unselected, incident stroke cases who reported to a general secondary hospital in an urban area without other alternative specialized health care facilities.…”

Section: Discussionmentioning

confidence: 99%

Poststroke Dementia

Barba

Martı́nez-Espinosa

Rodriguez-García

et al. 2000

Stroke

316

125

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Background and Purpose-The goal of the present study was to examine a series of putative risk factors of poststroke dementia (PSD), especially those factors usually associated with cerebrovascular disease and degenerative dementia, in a series of 251 consecutive unselected stroke patients. Methods-A standard protocol was prospectively applied at admission and 3 months after stroke; this protocol included clinical, functional, and cognitive assessments, hemogram and serum biochemistry, ECG and CT exams, apolipoprotein E and angiotensin-converting enzyme genotype, and neuropsychological examination. After a neuropsychological examination and an interview with a relative, the following diagnostic criteria were used: the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV for dementia after stroke, DSM-III-R for previous dementia and dementia stage, and Association Internationale pour la Recherche et l'Enseignement en Neurologie (NINDS-AIREN) for vascular dementia. Results-Seventy-five cases (30%) demonstrated dementia at 3-month follow up; 25 of them (10%) had demonstrated dementia before the stroke. Dementia was unrelated to type (ischemic/hemorrhagic) or location of stroke, vascular factors (hypertension, diabetes, ischemic heart disease, or hypercholesterolemia), apolipoprotein E or angiotensinconverting enzyme genotype, and serum homocysteine. Age (odds ratio [OR] 1.1, 95% CI 1.03 to 1.2), previous nephropathy (OR 6.1, 95% CI 1.5 to 24.3), atrial fibrillation (OR 4.4, 95% CI 1.4 to 13.9), low Canadian Neurological Scale score at discharge (OR 0.5, 95% CI 0.4 to 0.6), and previous mental decline assessed by the shortened Spanish version of the Informant Questionnaire on Cognitive Decline in the Elderly (SS-IQCODE; OR 1.2, 95% CI 1.1 to 1.4) were the correlates of dementia in logistic regression analyses. The same risks factors were found when cases with previous dementia and with hemorrhagic stroke were excluded. Conclusions-Dementia is frequent after ischemic or hemorrhagic stroke. Age, nephropathy, atrial fibrillation, previous mental decline, and stroke severity independently contribute to the risk.

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“…However, in epidemiologic studies (18), the number of cases of dementia that can be labeled as substantially stroke related is rather small. One reason for the low detection rate in clinical studies is the wellrecognized lack of sensitivity of clinical markers of stroke-related dementia (19)(20)(21)(22). A history of stroke causing cognitive impairment and the presence of infarcts on imaging are simply insensitive for identifying those patients with genuine cerebrovascular pathology.…”

mentioning

confidence: 99%

Invited Commentary: Albuminuria and Microvascular Disease of the Brain--A Shared Pathophysiology

Knopman¹

2010

American Journal of Epidemiology

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This commentary considers the implications of the association between albuminuria and cognitive decline described by Jassal et al. in this issue of the Journal (Am J Epidemiol. 2010;171(3):290-291). The authors report that men with albuminuria had a greater likelihood than men without albuminuria of experiencing declines in cognitive function over a 6.6-year period. Albuminuria is the result of endothelial damage in the kidney, which, in turn, is the result of microvascular disease. If one of the key mechanisms of brain microvascular disease is leakage of serum proteins into the brain extracellular space, in a fashion parallel to albuminuria that occurs in nephrosclerosis, several facets of cerebrovascular disease and cognitive decline are explained. First, brain microvascular disease would not be recognized by traditional clinical features of cerebrovascular disease because brain microvascular disease occurs gradually and insidiously. Second, the extravasation of serum proteins as a result of brain microvascular disease would account for the perivascular distribution of white matter hyperintensities on magnetic resonance imaging. Albuminuria might be a useful screening test for generalized microvascular disease and, if detected, might reasonably prompt brain imaging and more intensive therapeutic efforts to forestall further endothelial dysfunction in the kidney, brain, and elsewhere. aged; albuminuria; cognition; dementia; dementia, vascularIn this issue of the Journal, Jassal et al. (1) report that, in a cohort of 1,345 elders, those men with albuminuria were more likely than men without albuminuria to experience declines in cognitive function over a 6.6-year interval. The association was not found for women. Their study has a number of strengths, including its longitudinal design, large sample size, and multi-instrument cognitive assessment battery. The lack of association between albuminuria and cognitive decline in women was puzzling, and not fully explained. Nonetheless, the associations between albuminuria and cognitive decline in men were very consistent across multiple analytic approaches. The findings of Jassal et al. add to a growing body of work (2-6) that supports an association in older persons between changes in kidney function and changes in brain function. Why is it that something in the urine has anything to do with brain function? The answer lies in how and why protein gets into the urine.More so than glomerular filtration rate, the relation between microalbuminuria and vascular diseases of the kidney holds unique insights relevant to cerebrovascular disease.Both the brain and the kidney are highly vascular structures that respond to diseases such as hypertension and diabetes mellitus in similar ways at the microscopic level. In nephrosclerosis, gradual alterations in the kidney endothelial cells, glomeruli, and interstitial spaces lead to glomerular leakage of serum proteins into the urine (7,8). If a similar process were occurring at the endothelial level in brain microvessels, serum protei...

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Comparison of Different Diagnostic Criteria for Vascular Dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN)

Cited by 232 publications

References 37 publications

Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia

Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia

Poststroke Dementia

Invited Commentary: Albuminuria and Microvascular Disease of the Brain--A Shared Pathophysiology

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