Cited by 238Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsAcute Ischemic Stroke Management

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Comparison of Different Clinical Criteria (DSM-III, ADDTC, ICD-10, NINDS-AIREN, DSM-IV) for the Diagnosis of Vascular Dementia

Pohjasvaara, T., Mäntylä, R., Ylikoski, R., Kaste, M., Erkinjuntti, T.·2000·Stroke

DOI 10.1161/01.str.31.12.2952

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Abstract

Background and Purpose —The criteria for vascular dementia (VaD) include definition of the cognitive syndrome and the vascular cause. Different criteria for dementia identify different frequencies and clusters of patients. In addition, variation in defining the cause and etiology may have an effect. We compared different clinical criteria for VaD in series of patients with poststroke dementia. Methods —The study group comprised 107 patients fulfilling the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) definition for dementia from a cohort of consecutive patients with ischemic stroke who completed a comprehensive neuropsychological test battery and MRI. The mean age (SD) of the patients was 71.4 (7.6) years. The definitions of vascular cause of VaD were those of the DSM-III (1980), Alzheimer’s Disease Diagnostic and Treatment Centers (ADDTC; 1992), International Statistical Classification of Diseases, 10th Revision (ICD-10; 1992), National Institute of Neurological Disorders and Stroke–Association Internationale pour la Recherche et l’Enseignement en Neurosciences (NINDS-AIREN; 1993), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; 1994). Results —The number of cases that could be classified as VaD according to the different criteria varied considerably: 36.4% (n=39) by DSM-III, 86.9% (n=93) by ADDTC, 32.7% (n=35) by NINDS-AIREN, 36.4% (n=39) by ICD-10, and 91.6% (n=98) by DSM-IV criteria. The concordance between DSM-III/ICD-10 was perfect (100%; κ=1.0), between ICD-10/NINDS-AIREN and ADDTC/DSM-IV good to moderate (85.0% and 87.3%; κ=0.87 and 0.37, respectively), but otherwise poor between the other criteria. Only 31 patients fulfilled all the criteria for VaD applied. Major discriminating factors between the criteria were requirement of (1) focal neurological signs, (2) unequal distribution of deficits in higher cortical functions, and (3) evidence of relevant CVD based on brain imaging findings. Conclusions —Current criteria of VaD identify different frequencies and clusters of patients and are not interchangeable. Optimally, prospective studies with clinicopathological correlation could identify new criteria. Meanwhile, focus on more homogeneous subtypes (eg, small-vessel subcortical VaD) and detailed neuroimaging criteria could improve the diagnostics.

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10.1161/str.28.4.785 · DOI
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Authors: Pohjasvaara, T., Mäntylä, R., Ylikoski, R., Kaste, M., & Erkinjuntti, T.
Affiliations: University of Helsinki (FI)
ORCID: Kaste, M.
Venue: Stroke
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2000-12
Volume: 31
Issue: 12
Pages: 2952-2957
ISSN: 0039-2499 (ISSN-L)
1524-4628
DOI: 10.1161/01.str.31.12.2952
OpenAlex: W2105948419
Cited by: 238
References: 22
Citations by year: 2026: 4 · 2025: 3 · 2024: 2 · 2023: 8 · 2022: 2 · 2021: 8 · 2020: 6 · 2019: 12 · 2018: 6 · 2017: 6 · 2016: 5 · 2015: 7 · 2014: 10 · 2013: 8 · 2012: 15
FWCI: 5.07
Type: journal article
Language: en
Open access: closed
Locations: Stroke (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Neurological Disorders and Stroke
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
Keywords: vascular dementia, diagnostic criteria, post-stroke dementia, ischemic stroke, DSM-III, ICD-10, NINDS-AIREN criteria, DSM-IV, interobserver agreement, focal neurological signs, neuropsychological assessment, post-stroke cognitive impairment
MeSH terms: Aged, Brain Ischemia, Cognition Disorders, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neurologic Examination, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychometrics, Dementia, Vascular, Reproducibility of Results, Incidence, Prevalence, Stroke

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Comparison of Different Clinical Criteria (DSM-III, ADDTC, ICD-10, NINDS-AIREN, DSM-IV) for the Diagnosis of Vascular Dementia

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