Résumé
Background and purpose: There is a need for empirical studies to define criteria for vascular cognitive impairment (VCI) subtypes. In this paper, we report the predictive validity of a subtype classification scheme based on clinical and radiographic features. Methods: Nine Canadian memory clinics participated in the Consortium to Investigate Vascular Impairment of Cognition. This cohort consisted of 1347 patients, of whom 324 had VCI, and was followed for up to 30 months. Results: Clinical and neuroimaging features defined three subtypes: vascular cognitive impairment, no dementia, (n = 97), vascular dementia (n = 101) and mixed neurodegenerative/vascular dementia (n = 126). Any ischemic lesion on neuroimaging increased the odds (odds ratio = 9.31; 95% confidence interval 6.46, 13.39) of a VCI diagnosis. No VCI subtype, however, was associated with a specific neuroimaging abnormality. Compared to those with no cognitive impairment, patients with each VCI subtype had higher rates of death and institutionalization (hazard ratio for combined adverse events = 6.08, p < 0.001). Conclusions: Both clinical features and radiographic features help establish a diagnosis of VCI. The outcomes of VCI subtypes, however, are more strongly associated with clinical features than with radiographic ones.
| Langue d'origine | English |
|---|---|
| Pages (de-à) | 7-14 |
| Nombre de pages | 8 |
| Journal | Journal of the Neurological Sciences |
| Volume | 240 |
| Numéro de publication | 1-2 |
| DOI | |
| Statut de publication | Published - janv. 15 2006 |
Note bibliographique
Funding Information:The CIVIC study was funded by grants from the Medical Research Council of Canada through the PMAC/MRC program, with support from Hoechst Marion Roussel Canada, and by the Alzheimer Society of Canada. Additional funding for these analyses came from the Canadian Institutes of Health Research (CIHR) grant number MOP 62823.
Funding Information:
Kenneth Rockwood and Chris MacKnight receive support from the CIHR through Investigator and New Investigator awards, respectively. Kenneth Rockwood is also supported by the Dalhousie Medical Research Foundation as Kathryn Allen Weldon Professor of Alzheimer Research. David Hogan receives career support as the Brenda Strafford Foundation Chair in Geriatric Medicine at the University of Calgary.
Funding Information:
This is an original work that is not submitted elsewhere. Each of the coauthors has made a substantial contribution to the paper, as outlined. The study was sponsored by the Canadian Institutes of Health Research and in part by its predecessor, the Medical Research Council of Canada, then through a partnership program with the company once known as Hoechst Marion Roussel. None of the sponsors has had any role in the initiation of the work, the data collection, or the analysis of the data, which are located with and analysed by my group, allowing me to take public responsibility for the entire work.
ASJC Scopus Subject Areas
- Neurology
- Clinical Neurology