Use of Hachinski Ischemic Score in the memory clinic: Thai experience (original) (raw)
Related papers
Annals of the New York Academy of Sciences, 1997
The Hachinski Ischemic Score (HIS)' was originally developed to aid in the discrimination between multi-infarct dementia (MID) and Alzheimer's disease (AD), and it has gained wide acceptance for use in the clinical evaluation of patients with dementia. While it provides excellent sensitivity and specificity in the diagnostic discrimination between patients with A D (HIS 5 4) and MID (HIS 2 7), misclassifications can occur? The aim of this study was to identify the HIS items that contribute to misclassification in order to better understand the properties of the HIS and develop insights into the pathogenesis of A D and MID.
Discriminating power of the hachinski ischaemic score in a geriatric population with mild dementia
International Journal of Geriatric Psychiatry, 1995
The Hachinski Ischaemic Score (HIS) is used to clinically discriminate multi-infarct dementia (MID) and primary degenerative dementia (PDD). The present study aims to evaluate the discriminating power of the individual HIS items in a geriatric population with mild dementia. The 13 HIS items were studied in 93 demented subjects with no evidence of infarction, a single cortical infarct or multiple cortical infarcts on CT brain scan. The item 'hypertension' w.is a poor discriminator between PDD and MID in this elderly population; however, the remaining unambiguous items 'abrupt onset', 'neurological signs', 'neurological symptoms', 'history of stroke' and 'atherosclerosis' were useful discriminators. We found that five of the least discriminating items diverged from the aspects of MID that they were originally intended to address and were, therefore, particularly ambiguous. In order to improve the discriminating power of these items and the HIS as a whole, we recommend dividing the 13 items into four categories, 'evidence of delirium', 'evidence of focal deficits', 'evidence of vascular pathology' and 'abrupt onset', to minimize any problems with interpretation of the more ambiguous items.
Alzheimer's & Dementia, 2012
Objective: To determine whether neuropsychological tests and the Hachinski Ischemic Score (HIS) can differentiate incident vascular dementia (VaD) from Alzheimer's disease (AD) in nondemented older adults within 5 years of initial testing. This analysis included participants of the CSHA who (a) underwent neuropsychological testing and clinical assessment at CSHA-2 and were determined to be nondemented, and (b) underwent diagnostic assessment at CSHA-3. The outcome measure was CSHA-3 diagnosis, classified as VaD (n 5 22), probable or possible AD (n 5 65), and all other diagnostic outcomes (n 5 417). CSHA-3 diagnosticians were blinded to CSHA-2 test scores and diagnoses. Multinomial logistic regression with forward selection was used to determine the ability of the HIS and 15 CSHA-2 neuropsychological tests to predict CSHA-3 diagnostic outcome. The analysis was repeated after removing 15 AD cases with coexisting vascular disease. Results: The HIS and four neuropsychological tests were significant predictors of CSHA-3 diagnostic outcome (c 2 (14) 5 149.59, P , .001, R 2 5 0.38). Relative to developing VaD, higher HIS (odds ratio [OR]: 0.70; 95% confidence interval [CI]: 0.57-0.86) and Rey Auditory Verbal Learning Test immediate verbal recall scores (OR: 0.77; 95% CI: 0.62-0.97) were associated with lowered odds of developing AD, whereas higher phonemic fluency scores (OR: 1.21; 95% CI: 1.02-1.17) were associated with increased odds of developing AD. Removing AD cases with vascular disease did not affect results. Conclusions: In an epidemiological sample of nondemented participants, the HIS and two neuropsychological tests contributed to the differential prediction of VaD and AD within 5 years of initial measurement.
Validation of clinical criteria for possible vascular dementia in the oldest-old
Neurobiology of Aging, 2007
Although vascular dementia (VaD) is a main pathology in nonagenarians and centenarians, the validity of clinical criteria for this diagnosis is unknown. We analyzed 110 autopsy cases and reported sensitivities and specificities of the State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC) and National Institute for Neurological Disorders and Stroke (NINDS-AIREN) criteria for possible VaD as well as Hachinski ischemic score (HIS). Among them, there were 36 neuropathologically confirmed VaD cases. All criteria displayed comparable sensitivities (0.56-0.58). Specificities values were 0.74, 0.73 and 0.66, respectively. There was an age-related decrease on ADDTC criteria sensitivity due to the fact that 42% of pure VaD cases did not present with stroke. Thirty percent of mixed dementia (MD) cases were diagnosed as VaD by both NINDS-AIREN and ADDTC criteria. This proportion reached 45.9% for the HIS. These data demonstrate that the new diagnostic criteria for possible VaD do not provide a substantial gain of sensitivity compared to the HIS. Although their specificity was significantly lower in this age group compared to younger cohorts, all of them successfully exclude AD cases.
Folia Medica Indonesiana
Highlights: Characteristics of vascular dementia patients with a history of stroke was aimed. The most characteristics of vascular dementia patients with stroke history are men, post-ischemic stroke, hypertension grade 1, and lesions in the basal ganglia. : Stroke patients increase each year. Stroke is a cerebrovascular disorder caused by disruption of cerebral blood flow, which could reason vascular lesions within the mind parenchyma to be a threat to significant disorders. One of them is vascular dementia. Each affected person is prone to growing dementia after a stroke in three to five instances. Thisstudy aimed to decide the traits of patients with vascular dementia with a record of stroke. This study used a descriptive retrospective approach with a cross-sectional method. The samples were obtained from the total sampling technique. The sample of the study was vascular dementia patients with a stroke record at the National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono Ja...
Clinicopathological Validation Study of Four Sets of Clinical Criteria for Vascular Dementia
American Journal of Psychiatry, 2002
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
Dementia and Geriatric …, 2011
Background: Subcortical ischemic vascular dementia (SIVD) has been proposed as the most frequent subtype of vascular cognitive impairment. The aim of this study was to evaluate the psychometric properties of the Chinese (Cantonese) Montreal Cognitive Assessment (CC-MoCA) in patients with SIVD in the Guangdong Province of China. Methods: 71 SIVD patients and 60 matched controls were recruited for the CC-MoCA, Mini Mental State Examination and executive clock drawing tasks. Receiver-operating characteristic curve analyses were performed to determine optimal sensitivity and specificity of the CC-MoCA total score in differentiating mild vascular dementia (VaD) patients from moderate VaD patients and controls. Results: The mean CC-MoCA scores of the controls, and mild and moderate VaD patients were 25.2 8 3.8, 16.4 8 3.7, and 10.0 8 5.1, respectively. In our study, the optimal cutoff value for the CC-MoCA to be able to differentiate patients with mild VaD from controls is 21/22, and 13/14 to differentiate mild VaD from moderate VaD. Conclusion: The CC-MoCA is a useful cognitive screening instrument in SIVD patients.
Stroke, 2000
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...
Vascular dementia: Clinical and neuroradiological correlation
Medicinski pregled, 2011
All stroke patients admitted to Banjaluka Clinical Centre during one year were evaluated by the standard protocol during the hospitalization and three months after the stroke. It included clinical, functional and neuropsychological examination and neuroimaging. Dementia was diagnosed according to the criteria of National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l?Enseignement en Neurosciences. Demographic and clinical variables were examined. After the exclusion of the patients who died (n=139) and those who refused to be interviewed during the 3-month follow up (n=52) and those with pre-stroke dementia (n=22), a total of 273 (58.8%) patients underwent neuropsychological examination 3 months after the stroke. Fortynine (19.52%) of them met the criteria for vascular dementia. The predictors of vascular dementia were age, atrial fibrillation, cognitive and functional impairment on admission and functional outcome, subcortical lacun...