Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Gold, G. Articles by Giannakopoulos, P. Search for Related Content PubMed Citation Articles by Gold, G. Articles by Giannakopoulos, P. Dementias (General) Diagnostic Criteria Neurodegeneration

Clinicopathological Validation Study of Four Sets of Clinical Criteria for Vascular Dementia

OBJECTIVE: The authors’ goal was to validate the clinical criteria for vascular dementia of the State of California Alzheimer’s Disease Diagnostic and Treatment Centers (ADDTC), the National Institute for Neurological Disorders and Stroke–Association Internationale pour la Recherche et l’Enseignement en Neurosciences (NINDS-AIREN), DSM-IV, and ICD-10. METHOD: Sensitivity and specificity were assessed by comparing the clinical with the neuropathological diagnosis of 89 autopsied patients with dementia from a geriatric and psychiatric hospital. All cases were reviewed by a clinician and a neuropathologist who were blind to each other’s findings. RESULTS: Neuropathologically there were 20 cases of vascular dementia, 23 cases of mixed dementia, and 46 cases of Alzheimer’s disease among the autopsied patients. The sensitivity was 0.50 for DSM-IV criteria for vascular dementia, 0.70 for ADDTC criteria for possible vascular dementia, 0.55 for NINDS-AIREN criteria for possible vascular dementia, 0.20 for ICD-10 criteria for vascular dementia, 0.25 for ADDTC criteria for probable vascular dementia, and 0.20 for NINDS-AIREN criteria for probable vascular dementia. Specificity was 0.84, 0.78, 0.84, 0.94, 0.91, and 0.93, respectively. The proportion of cases clinically classified as vascular dementia ranged from 0% to 13% for neuropathologically confirmed cases of Alzheimer’s disease and 9% to 39% for neuropathologically confirmed cases of mixed dementia. There was no statistically significant relationship between the neuropathological diagnosis and three of the clinical criteria sets studied (ICD-10 criteria for vascular dementia and ADDTC and NINDS-AIREN criteria for probable vascular dementia). CONCLUSIONS: Clinical criteria for vascular dementia are not interchangeable. The ADDTC criteria for possible vascular dementia are the most sensitive for the detection of vascular dementia; however, the DSM-IV criteria for vascular dementia and the NINDS-AIREN criteria for possible vascular dementia may be more effective in excluding mixed dementia. Given their inability to detect the vast majority of cases of vascular dementia, the ICD-10 criteria for vascular dementia and the ADDTC and NINDS-AIREN criteria for probable vascular dementia should be revised.

This article has been cited by other articles:

				M. S. J. Elliott, C. G. Ballard, R. N. Kalaria, R. Perry, T. Hortobagyi, and P. T. Francis Increased binding to 5-HT1A and 5-HT2A receptors is associated with large vessel infarction and relative preservation of cognition Brain, July 1, 2009; 132(7): 1858 - 1865. [Abstract] [Full Text] [PDF]

				N. J.G. Pimlott, M. Persaud, N. Drummond, C. A. Cohen, J. L. Silvius, K. Seigel, G. R. Hollingworth, and W. B. Dalziel Family physicians and dementia in Canada: Part 2. Understanding the challenges of dementia care Can Fam Physician, May 1, 2009; 55(5): 508 - 509.e7. [Abstract] [Full Text] [PDF]

				S. Wiederkehr, M. Simard, C. Fortin, and R. van Reekum Validity of the Clinical Diagnostic Criteria for Vascular Dementia: A Critical Review. Part II J Neuropsychiatry Clin Neurosci, May 1, 2008; 20(2): 162 - 177. [Abstract] [Full Text] [PDF]

				S. Benisty, K. Hernandez, A. Viswanathan, S. Reyes, A. Kurtz, M. O'Sullivan, M.-G. Bousser, M. Dichgans, and H. Chabriat Diagnostic Criteria of Vascular Dementia in CADASIL Stroke, March 1, 2008; 39(3): 838 - 844. [Abstract] [Full Text] [PDF]

				J T O'BRIEN Role of imaging techniques in the diagnosis of dementia Br. J. Radiol., December 1, 2007; 80(Special_Issue_2): S71 - S77. [Abstract] [Full Text] [PDF]

				D S KNOPMAN Cerebrovascular disease and dementia Br. J. Radiol., December 1, 2007; 80(Special_Issue_2): S121 - S127. [Abstract] [Full Text] [PDF]

				A. P. Auchus, H. R. Brashear, S. Salloway, A. D. Korczyn, P. P. De Deyn, C. Gassmann-Mayer, and For the GAL-INT-26 Study Group Galantamine treatment of vascular dementia: A randomized trial Neurology, July 31, 2007; 69(5): 448 - 458. [Abstract] [Full Text] [PDF]

				T. S.M. Reijn, M. O. Rikkert, W. J.A. van Geel, D. de Jong, and M. M. Verbeek Diagnostic Accuracy of ELISA and xMAP Technology for Analysis of Amyloid {beta}42 and Tau Proteins Clin. Chem., May 1, 2007; 53(5): 859 - 865. [Abstract] [Full Text] [PDF]

				A. Gamaldo, A. Moghekar, S. Kilada, S. M. Resnick, A. B. Zonderman, and R. O'Brien Effect of a clinical stroke on the risk of dementia in a prospective cohort Neurology, October 24, 2006; 67(8): 1363 - 1369. [Abstract] [Full Text] [PDF]

				D. de Jong, R. W. M. M. Jansen, B. P. H. Kremer, and M. M. Verbeek Cerebrospinal Fluid Amyloid {beta}42/Phosphorylated Tau Ratio Discriminates Between Alzheimer's Disease and Vascular Dementia. J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2006; 61(7): 755 - 758. [Abstract] [Full Text] [PDF]

				P. Pytel, E. J. Cochran, G. Bonner, D. L. Nyenhuis, C. Thomas, and P. B. Gorelick Vascular and Alzheimer-type pathology in an autopsy study of African-Americans Neurology, February 14, 2006; 66(3): 433 - 435. [Abstract] [Full Text] [PDF]

				J-L Fuh, S-J Wang, and J L Cummings Neuropsychiatric profiles in patients with Alzheimer's disease and vascular dementia J. Neurol. Neurosurg. Psychiatry, October 1, 2005; 76(10): 1337 - 1341. [Abstract] [Full Text] [PDF]

				C. C. Price, A. L. Jefferson, J. G. Merino, K. M. Heilman, and D. J. Libon Subcortical vascular dementia: Integrating neuropsychological and neuroradiologic data Neurology, August 9, 2005; 65(3): 376 - 382. [Abstract] [Full Text] [PDF]

				O. L. Lopez, L. H. Kuller, J. T. Becker, W. J. Jagust, S. T. DeKosky, A. Fitzpatrick, J. Breitner, C. Lyketsos, C. Kawas, and M. Carlson Classification of vascular dementia in the Cardiovascular Health Study Cognition Study Neurology, May 10, 2005; 64(9): 1539 - 1547. [Abstract] [Full Text] [PDF]

				Z.-X. Zhang, G. E. P. Zahner, G. C. Roman, J. Liu, Z. Hong, Q.-M. Qu, X.-H. Liu, X.-J. Zhang, B. Zhou, C.-B. Wu, et al. Dementia Subtypes in China: Prevalence in Beijing, Xian, Shanghai, and Chengdu Arch Neurol, March 1, 2005; 62(3): 447 - 453. [Abstract] [Full Text] [PDF]

				C. G. Ballard, E. J. Burton, R. Barber, S. Stephens, R. A. Kenny, R. N. Kalaria, and J. T. O'Brien NINDS AIREN neuroimaging criteria do not distinguish stroke patients with and without dementia Neurology, September 28, 2004; 63(6): 983 - 988. [Abstract] [Full Text] [PDF]

				T. Erkinjuntti, G. Roman, S. Gauthier, H. Feldman, and K. Rockwood Emerging Therapies for Vascular Dementia and Vascular Cognitive Impairment Stroke, April 1, 2004; 35(4): 1010 - 1017. [Abstract] [Full Text] [PDF]

				D. S. Knopman, J. E. Parisi, B. F. Boeve, R. H. Cha, H. Apaydin, A. Salviati, S. D. Edland, and W. A. Rocca Vascular Dementia in a Population-Based Autopsy Study Arch Neurol, April 1, 2003; 60(4): 569 - 575. [Abstract] [Full Text] [PDF]

				L. PANTONI and D. INZITARI Pathological Examination in Vascular Dementia Am J Psychiatry, August 1, 2002; 159(8): 1439 - 1440. [Full Text]

Get information about faster international access.

Privacy Policy

Copyright © 2002 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us