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 language | English (US) |
|---|---|
| Pages (from-to) | 19-29 |
| Number of pages | 11 |
| Journal | Alzheimer's and Dementia |
| Volume | 1 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 2005 |
| Externally published | Yes |
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Keywords
- Cognitive symptoms
- Dementia
- Early diagnosis
- Multivariate analyses
- Neuropsychological tests
- Vascular cognitive impairment
ASJC Scopus subject areas
- Health Policy
- Epidemiology
- Geriatrics and Gerontology
- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Developmental Neuroscience
- Clinical Neurology
Cite this
Identification of VaD and AD prodromes : The Cache County Study. / Hayden, K. M.; Warren, L. H.; Pieper, C. F.; Østbye, T.; Tschanz, J. T.; Norton, M. C.; Breitner, John C.S.; Welsh-Bohmer, K. A.
In: Alzheimer's and Dementia, Vol. 1, No. 1, 07.2005, p. 19-29.Research output: Contribution to journal › Article
}
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, John C.S.
AU - Welsh-Bohmer, K. A.
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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UR - http://www.scopus.com/inward/citedby.url?scp=33644799977&partnerID=8YFLogxK
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 -