Identification of VaD and AD prodromes: The Cache County Study

K. M. Hayden, L. H. Warren, C. F. Pieper, T. Østbye, J. T. Tschanz, M. C. Norton, J. C.S. Breitner, K. A. Welsh-Bohmer

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)19-29
Number of pages11
JournalAlzheimer's and Dementia
Volume1
Issue number1
DOIs
StatePublished - Jul 1 2005
Externally publishedYes

Keywords

  • Cognitive symptoms
  • Dementia
  • Early diagnosis
  • Multivariate analyses
  • Neuropsychological tests
  • Vascular cognitive impairment

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience

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  • Cite this

    Hayden, K. M., Warren, L. H., Pieper, C. F., Østbye, T., Tschanz, J. T., Norton, M. C., Breitner, J. C. S., & Welsh-Bohmer, K. A. (2005). Identification of VaD and AD prodromes: The Cache County Study. Alzheimer's and Dementia, 1(1), 19-29. https://doi.org/10.1016/j.jalz.2005.06.002