Impact of Applying NINDS-AIREN Criteria of Probable Vascular Dementia to Clinical and Radiological Characteristics of a Stroke Cohort with DementiaTang W.K.a · Chan S.S.M.a · Chiu H.F.K.a,d · Ungvari G.S.a · Wong K.S.b · Kwok T.C.Y.b · Mok V.b · Wong K.T.c · Richards P.S.c · Ahuja A.T.c
aDepartment of Psychiatry, bDepartment of Medicine and Geriatrics, and cDepartment of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, and dJockey Club Centre for Positive Ageing, Hong Kong, SAR, China
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background: There are no data concerning the relative representation of clinical vascular risk factors and radiological lesions in cases that have been ruled in and ruled out for probable vascular dementia (VaD) according to NINDS-AIREN criteria. Methods: Three months after their index stroke, a psychiatrist interviewed patients and made a diagnosis of VaD according to both DSM-IV and NINDS-AIREN criteria for probable VaD. Patients who fulfilled the DSM-IV criteria for VaD were divided into two groups: those who were ruled in and ruled out according to NINDS-AIREN criteria as probable VaD. Demographic characteristics, vascular risk factors, clinical features of the index stroke and radiological findings were then compared between the two groups. Results: Of the 297 patients screened, 56 (18.8%) had a DSM-IV diagnosis of dementia. Among these demented patients, 55 (98.2%) and 22 (39.3%) fulfilled DSM-IV and NINDS-AIREN diagnosis of VaD, respectively. The concordance and level of agreement (kappa statistic) between DSM-IV and NINDS-AIREN diagnoses were 40% and 0.02, respectively. Reasons of failure to meet NINDS-AIREN criteria included the lack of temporal relationship between dementia and stroke (n = 20), the absence of focal neurological signs and/or radiological evidence of stroke (n = 6) and both of the above (n = 7). There was no significant difference between the above two groups in terms of demographic data, features of index stroke, vascular risk factors and CT scan findings, except that leukoaraiosis (p = 0.021) and bilateral lesions (p = 0.015) were more frequent in subjects diagnosed according to NINDS-AIREN criteria of probable VaD. The difference between these two groups with respect to the number of lesions was borderline for significance (p = 0.052). Conclusions: The use of NINDS-AIREN criteria for VaD for case selection in poststroke dementia research may exclude a number of subjects with VaD.
© 2004 S. Karger AG, Basel
- Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K, Desmond DW: Limitations of clinical criteria for the diagnosis of vascular dementia in clinical trials: Is a focus on subcortical vascular dementia a solution? Ann NY Acad Sci 2000;903:262–272.
Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A: Vascular dementia: Diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
- Chui HC, Mack W, Jackson JE, Mungas D, Reed BR, Tinklenberg J, Chang FL, Skinner K, Tasaki C, Jagust WJ: Clinical criteria for the diagnosis of vascular dementia: A multicenter study of comparability and interrater reliability. Arch Neurol 2000;57:191–196.
- Pohjasvaara T, Mantyla R, Ylikoski R, Kaste M, Erkinjuntti T: Comparison of different clinical criteria (DSM-III, ADDTC, ICD-10, NINDS-AIREN, DSM-IV) for the diagnosis of vascular dementia. National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l’Enseignement en Neurosciences. Stroke 2000;31:2952–2957.
- Inzitari D, Di Carlo A, Pracucci G, Lamassa M, Vanni P, Romanelli M, Spolveri S, Adriani P, Meucci I, Landini G, Ghetti A: Incidence and determinants of poststroke dementia as defined by an informant interview method in a hospital-based stroke registry. Stroke 1998;29:2087–2093.
- Pohjasvaara T, Erkinjunti T, Yilkoski R, Hietanen M, Vataja R, Kaste M: Clinical determinants of poststroke dementia. Stroke 1998;29:75–81.
- Madureira S, Guerreiro M, Ferro JM: Dementia and cognitive impairment three months after stroke. Eur J Neurol 2001;8:621–627.
Anonymous: Stroke 1989: Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke 1989;20:1407–1431.
- Fuh JL, Teng EL, Lin KN: The informant questionnaire on cognitive decline in the elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology 1995;45:92–96.
Chiu HFK, Lee HCB, Chung D: Reliability and validity of the Cantonese version of the Mini-Mental State Examination: A preliminary study. Hong Kong J Psychiatry 1994:4(suppl 2):25–28.
- Morris JC: The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology 1993;43:2412–2414.
- van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J: Interobserver agreement for the assessment of handicap in stroke patients. Stroke 1988;19:604–607.
- Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, Spilker J, Holleran R, Eberle R, Hertberg V: Measurement of acute cerebral infarctions: A clinical examination scale. Stroke 1989;20:864–870.
- Henon H, Godefroy O, Luca CH, Pruvo JP, Leys D: Risk factors and leukoaraiosis in stroke patients. Acta Neurol Scand 1996;94:137–144.
- Kawamura J, Meyer JS, Terayama Y, Weathers S: Cerebral hypoperfusion correlates with mild and parenchymal loss with severe multi-infarct dementia. J Neurol Sci 1991;102:32–38.
- Lopez OL, Larumbe MR, Becker JT, Rezek D, Rosen J, Klunk W, DeKosky ST: Reliability of NINDS-AIREN clinical criteria for the diagnosis of vascular dementia. Neurology 1994;44:1240–1245.
- Gold G, Bouras C, Canuto A, Bergallo MF, Herrmann FR, Hof PR, Mayor PA, Michel JP, Giannakopoulos P: Clinicopathological validation study of four sets of clinical criteria for vascular dementia. Am J Psychiatry 2002;159:82–87.
- Pantoni L, Palumbo V, Sarti C: Pathological lesions in vascular dementia. Ann NY Acad Sci 2002;977:279–291.
- Damasio H: A computed tomographic guide to the identification of cerebral vascular territories. Arch Neurol 1983;40:715–719.
- Wetterling T, Kanitz RD, Borgis KJ: Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). Stroke 1996;27:30–36.
- Gold G, Giannakopoulos P, Montes-Paixao C Jr, Herrmann FR, Mulligan R, Michel JP, Bouras C: Sensitivity and specificity of newly proposed clinical criteria for possible vascular dementia. Neurology 1997;49:690–694.
- Holmes C, Cairns N, Lantos P, Mann A: Validity of current clinical criteria for Alzheimer’s disease, vascular dementia and dementia with Lewy bodies. Br J Psychiatry 1999;174:45–50.
- Desmond DW, Moroney JT, Paik MC: Frequency and clinical determinants of dementia after ischemic stroke. Neurology 2000;54:1124–1131.
- Censori B, Manara O, Agostinis Camerlingo M, Casto l, Galavotti B, Partziguian T, Servalli MC, Casana B, Belloni G, Mamoli A: Dementia after first stroke. Stroke 1996;27:1205–1210.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.