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The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.

Meta-analysis of the Hachinski Ischemic Score in pathologically verified dementias

Moroney, J. T., Bagiella, E., Desmond, D. W., Hachinski, V. C., Mölsä, P. K., Gustafson, L., Brun, A., Fischer, P., Erkinjuntti, T., Rosen, W., Paik, M. C., Tatemichi, T. K.·1997·Neurology
DOI 10.1212/wnl.49.4.1096
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Abstract

Our objectives were to investigate the utility of the Hachinski Ischemic Score (HIS) in differentiating patients with pathologically verified Alzheimer's disease (AD), multi-infarct dementia (MID), and "mixed" (AD plus cerebrovascular disease) dementia, and to identify the specific items of the HIS that best discriminate those dementia subtypes. Investigators from six sites participated in a meta-analysis by contributing original clinical data, HIS, and pathologic diagnoses on 312 patients with dementia (AD, 191; MID, 80; and mixed, 41). Sensitivity and specificity of the HIS were calculated based on varied cutoffs using receiver-operator characteristic curves. Logistic regression analyses were performed to compare each pair of diagnostic groups to obtain the odds ratio (OR) for each HIS item. The mean HIS (+/- SD) was 5.4 +/- 4.5 and differed significantly among the groups (AD, 3.1 +/- 2.5; MID, 10.5 +/- 4.1; mixed, 7.7 +/- 4.3). Receiver-operator characteristic curves showed that the best cutoff was < or = 4 for AD and > or = 7 for MID, as originally proposed, with a sensitivity of 89.0% and a specificity of 89.3%. For the comparison of MID versus mixed the sensitivity was 93.1% and the specificity was 17.2%, whereas for AD versus mixed the sensitivity was 83.8% and the specificity was 29.4%. HIS items distinguishing MID from AD were stepwise deterioration (OR, 6.06), fluctuating course (OR, 7.60), hypertension (OR, 4.30), history of stroke (OR, 4.30), and focal neurologic symptoms (OR, 4.40). Only stepwise deterioration (OR, 3.97) and emotional incontinence (OR, 3.39) distinguished MID from mixed, and only fluctuating course (OR, 0.20) and history of stroke (OR, 0.08) distinguished AD from mixed. Our findings suggest that the HIS performed well in the differentiation between AD and MID, the purpose for which it was originally designed, but that the clinical diagnosis of mixed dementia remains difficult. Further prospective studies of the HIS should include additional clinical and neuroimaging variables to permit objective refinement of the scale and improve its ability to identify patients with mixed dementia.

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Metadata

Authors
Moroney, J. T., Bagiella, E., Desmond, D. W., Hachinski, V. C., Mölsä, P. K., Gustafson, L., Brun, A., Fischer, P., Erkinjuntti, T., Rosen, W., Paik, M. C., & Tatemichi, T. K.
Venue
Neurology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1997-10
Volume
49
Issue
4
Pages
1096-1105
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
DOI
10.1212/wnl.49.4.1096
OpenAlex
W2149714450
Cited by
316
References
21
FWCI
1.45
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Meta-analysis of the Hachinski Ischemic Score in pathologically verified dementias. https://app.cochat.ai/papers/10.1212/wnl.49.4.1096
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Moroney, J. T., Bagiella, E., Desmond, D. W., Hachinski, V. C., Mölsä, P. K., Gustafson, L., Brun, A., Fischer, P., Erkinjuntti, T., Rosen, W., Paik, M. C., & Tatemichi, T. K. (1997). Meta-analysis of the Hachinski Ischemic Score in pathologically verified dementias. Neurology. https://doi.org/10.1212/wnl.49.4.1096

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