Cited by 109Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsCerebrovascular and genetic disorders

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Classification of vascular dementia in the Cardiovascular Health Study Cognition Study

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Lopez, O. L., Kuller, L. H., Becker, J. T., Jagust, W. J., DeKosky, S. T., Fitzpatrick, A., Breitner, J., Lyketsos, C., Kawas, C., Carlson, M.·2005·Neurology

DOI 10.1212/01.wnl.0000159860.19413.c4

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Abstract

OBJECTIVE: To describe the diagnostic classification of subjects with incident vascular dementia (VaD) participating in the Cardiovascular Health Study (CHS) Cognition Study. METHODS: The CHS classified 480 incident cases between 1994 and 1999 among 3,608 CHS participants who had brain MRI in 1992 through 1994 and in 1997 through 1998. The patients were diagnosed before and after reviewing the brain MRI. RESULTS: The pre-MRI classification showed that 52 participants had VaD and 76 had both Alzheimer disease (AD) and VaD. The post-MRI classification showed that the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria classified 61 subjects as having VaD, the National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria classified 43 subjects as having probable VaD and 10 as possible VaD, and the State of California Alzheimer's Disease Diagnostic and Treatment Center (ADDTC) criteria classified 117 as having probable VaD and 96 as possible. The combination of the ADDTC and National Institute of Neurological and Communication Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria was used to examine the spectrum of vascular disease in dementia. The dementia was attributable to only vascular factors in 56 cases (probable VaD); VaD coexisted with AD in 61 cases, although the VaD component was the leading cause of dementia (probable VaD with AD); AD was the leading cause of dementia in 61 cases (possible VaD and probable AD); and in 29 cases, it was not clear that either AD or VaD was the primary diagnosis (possible AD and possible VaD). CONCLUSIONS: None of the clinical criteria for VaD identified the same group of subjects. The diagnosis of vascular dementia is difficult in epidemiologic studies because poststroke dementia can be due to Alzheimer disease (AD) and evidence of vascular disease can be found in the MRI of dementia cases without clinical strokes. Whether the clinical progression is related to AD pathology or vascular disease is difficult to establish.

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Authors: Lopez, O. L., Kuller, L. H., Becker, J. T., Jagust, W. J., DeKosky, S. T., Fitzpatrick, A., Breitner, J., Lyketsos, C., Kawas, C., & Carlson, M.
Affiliations: From the Departments of Neurology and Psychiatry (Drs. Lopez, Becker, and DeKosky), University of Pittsburgh School of Medicine, and Department of Epidemiology (Dr. Kuller), University of Pittsburgh Graduate School of Public Health, PA, University of California at Berkeley (W.J. Jagust), Department of Biostatistics (Dr. Fitzpatrick), University of Washington, and Geriatric Research, Education, and Clinical Center (Dr. Breitner), Veterans Administration Puget Sound Health Care System, Seattle, WA,...
University of Pittsburgh (US)
ORCID: Kuller, L. H.
Becker, J. T.
DeKosky, S. T.
Breitner, J.
Lyketsos, C.
Kawas, C.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-05-10
Volume: 64
Issue: 9
Pages: 1539-1547
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/01.wnl.0000159860.19413.c4
OpenAlex: W1974020386
Cited by: 109
References: 53
Citations by year: 2026: 3 · 2023: 6 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 4 · 2012: 4
FWCI: 7.65
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders: National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc035129-010)
National Institute on Aging (AG 20098, AG-15928, R01AG015928)
National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01HC-85083, N01HC15103, N01HC85082, N01 HC85086, N01HC85080, N01-HC85079, N01-HC85084, N01HC35129)
National Institute of Mental Health (MH07033)
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 › Cerebrovascular and genetic disorders
Keywords: vascular dementia, Alzheimer's disease, dementia classification, diagnostic criteria, brain MRI, post-stroke dementia, vascular disease, Cardiovascular Health Study, NINDS-AIREN criteria, DSM-IV diagnostic criteria, mixed dementia
MeSH terms: Aged, Aged, 80 and over, Alzheimer Disease, Brain, Cerebral Arteries, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Male, Predictive Value of Tests, United States, Dementia, Vascular, Cohort Studies, Disease Progression, Stroke

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