TY - JOUR
T1 - Identification of VaD and AD prodromes
T2 - The Cache County Study
AU - Hayden, K. M.
AU - Warren, L. H.
AU - Pieper, C. F.
AU - Østbye, T.
AU - Tschanz, J. T.
AU - Norton, M. C.
AU - Breitner, J. C.S.
AU - Welsh-Bohmer, K. A.
N1 - Funding Information:
The authors thank Dr. Constantine Lyketsos for his thoughtful review of this manuscript and Dr. Jeffrey Browndyke for his suggestions on discrimination and response bias indices. This work was supported by NIH grant AG-11380 and the work of Dr. Hayden by T32-AG00029. We are grateful to the neurogenetics laboratory of the Bryan Alzheimer’s Dementia Research Center at Duke University for the APOE genotyping, and to Tony Calvert, BSC, Michelle McCart, BA, Cara Brewer, BA, Nancy Sassano, PhD, Roxane Pfister, MA, and Joslin Werstack, BA for expert technical assistance. Other Cache County Investigators include James Anthony, PhD, Erin Bigler, PhD, Ron Brookmeyer, PhD, James Burke, MD, Eric Christopher, MD, Chris Corcoran, PhD, Jane Gagliardi, MD, Robert Green, MD, Michael Helms, MS, Christine Hulette, MD, Liz Klein, MPH, Carol Leslie, MS, Constantine Lyketsos, MD, MHS, Lawrence Mayer, MD, John Morris, MD, Ron Munger, PhD, MPH, Chiadi Onyike, MD, MHS, Ron Petersen, MD, Kathy Piercy, PhD, Brenda Plassman, PhD, Peter Rabins, MD, Pritham Raj, MD, Russell Ray, MS, Linda Sanders, MPH, Ingmar Skoog, MD, David Steffens, MD, Martin Steinberg, MD, Marty Toohill, PhD, Leslie Toone, MS, Jeannette Townsend, MD, Heidi Wengreen, PhD, Michael Williams, MD, Bonita Wyse, PhD, and Peter Zandi, PhD.
PY - 2005/7
Y1 - 2005/7
N2 - Background: It is unclear whether vascular dementia (VaD) has a cognitive prodrome, akin to the mild cognitive impairment (MCI) prodrome to Alzheimer's dementia (AD). To evaluate whether VaD has a cognitive prodrome, and if it can be differentiated from prodromal AD, we examined neuropsychological test performance of participants in a nested case-control study within a population-based cohort aged 65 or older. Methods: Participants (n = 485) were identified from the Cache County Study, a large population-based study of aging and dementia. After an average of 3 years of follow-up, a total of 62 incident dementia cases were identified (14 VaD, 48 AD). We identified a number of neuropsychological tests (executive and memory) that discriminated between diagnosed VaD and AD cases. Multivariate analyses sought to differentiate between these same groups 3 years before clinical diagnosis. Results: The Consortium to Establish a Registry for Alzheimer's Disease Word List Recognition Test correct recognition of foils (mean difference, 1.25; 95% confidence interval [CI], 0.42 to 2.07; p < 0.01), Logical Memory I (mean difference, 7.16; 95% CI, 0.78 to 13.55, p < 0.05), Logical Memory II delayed recall (mean difference, 8.67; 95% CI, 1.59 to 15.74, p < 0.05), and percent savings (mean difference, 51.07; 95% CI, 32.58 to 69.56, p < 0.0001) differentiated VaD from AD cases after adjustment for age, sex, education, and dementia severity. Three years before dementia diagnosis, word list recognition ("no" responses mean difference, 1.40; 95% CI, 0.64 to 2.17; p < 0.001, and "yes" responses mean difference, -1.14; 95% CI, -2.14 to -0.13; p < 0.03) discriminated between prodromal VaD and AD. Conclusion: These results suggest that VaD has a prodromal syndrome, the cognitive features of which are distinguishable from the cognitive prodrome of AD.
AB - Background: It is unclear whether vascular dementia (VaD) has a cognitive prodrome, akin to the mild cognitive impairment (MCI) prodrome to Alzheimer's dementia (AD). To evaluate whether VaD has a cognitive prodrome, and if it can be differentiated from prodromal AD, we examined neuropsychological test performance of participants in a nested case-control study within a population-based cohort aged 65 or older. Methods: Participants (n = 485) were identified from the Cache County Study, a large population-based study of aging and dementia. After an average of 3 years of follow-up, a total of 62 incident dementia cases were identified (14 VaD, 48 AD). We identified a number of neuropsychological tests (executive and memory) that discriminated between diagnosed VaD and AD cases. Multivariate analyses sought to differentiate between these same groups 3 years before clinical diagnosis. Results: The Consortium to Establish a Registry for Alzheimer's Disease Word List Recognition Test correct recognition of foils (mean difference, 1.25; 95% confidence interval [CI], 0.42 to 2.07; p < 0.01), Logical Memory I (mean difference, 7.16; 95% CI, 0.78 to 13.55, p < 0.05), Logical Memory II delayed recall (mean difference, 8.67; 95% CI, 1.59 to 15.74, p < 0.05), and percent savings (mean difference, 51.07; 95% CI, 32.58 to 69.56, p < 0.0001) differentiated VaD from AD cases after adjustment for age, sex, education, and dementia severity. Three years before dementia diagnosis, word list recognition ("no" responses mean difference, 1.40; 95% CI, 0.64 to 2.17; p < 0.001, and "yes" responses mean difference, -1.14; 95% CI, -2.14 to -0.13; p < 0.03) discriminated between prodromal VaD and AD. Conclusion: These results suggest that VaD has a prodromal syndrome, the cognitive features of which are distinguishable from the cognitive prodrome of AD.
KW - Cognitive symptoms
KW - Dementia
KW - Early diagnosis
KW - Multivariate analyses
KW - Neuropsychological tests
KW - Vascular cognitive impairment
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U2 - 10.1016/j.jalz.2005.06.002
DO - 10.1016/j.jalz.2005.06.002
M3 - Article
C2 - 19595812
AN - SCOPUS:33644799977
VL - 1
SP - 19
EP - 29
JO - Alzheimer's and Dementia
JF - Alzheimer's and Dementia
SN - 1552-5260
IS - 1
ER -