Coexisting Cerebral Infarction in Alzheimer's Disease Is Associated with Fast Dementia Progression: Applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction
OBJECTIVES: To determine whether patients with Alzheimer's disease (AD) and coexisting cerebral infarction (CI) that satisfy the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS‐AIREN) neuroimagi...
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Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2007-06, Vol.55 (6), p.918-922 |
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creator | Sheng, Bun Cheng, Lik Fai Law, Chun Bon Li, Ho Lun Yeung, Kwan Mo Lau, Kwok Kwong |
description | OBJECTIVES: To determine whether patients with Alzheimer's disease (AD) and coexisting cerebral infarction (CI) that satisfy the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS‐AIREN) neuroimaging criteria for vascular dementia (VaD) progress faster than those who do not satisfy the neuroimaging criteria.
DESIGN: Retrospective cohort study.
SETTING: Multidisciplinary memory clinic in a tertiary hospital.
PARTICIPANTS: One hundred thirty consecutive patients with AD, with or without CI, followed up regularly for more than 1 year.
MEASUREMENTS: The patients were classified according to the distribution and severity of CI as defined according to the NINDS‐AIREN neuroimaging criteria into those with AD and no CI (AD‐N), those with AD and CI not fulfilling neuroimaging criteria (AD‐I), and those with AD and CI fulfilling neuroimaging criteria (AD‐V), and their differences in dementia progression were tested. The loss of independence, indicated by institution admission or a clinical dementia rating (CDR) score of 3, was defined as the endpoint for a poor outcome.
RESULTS: The mean age was 75.8, and 68.5% were women. The initial Mini‐Mental State Examination (MMSE) score was 15.3±0.4, and the average duration of follow up was 30.4 months. Fifty‐four patients had reached study endpoint at the time of analysis. AD‐V (hazard ratio (HR)=3.1, 95% confidence interval (CI)=1.2–8.2), use of psychotropic drugs (HR=2.7, 95% CI=1.1–6.4), and initial MMSE score (HR=0.9, 95% CI=0.8–1.0) were independent predictors of poor outcome in the Cox regression model.
CONCLUSION: In AD, co‐occurrence of CI with distribution and severity as defined in the NINDS‐AIREN neuroimaging criteria for VaD is associated with faster dementia progression. |
doi_str_mv | 10.1111/j.1532-5415.2007.01171.x |
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DESIGN: Retrospective cohort study.
SETTING: Multidisciplinary memory clinic in a tertiary hospital.
PARTICIPANTS: One hundred thirty consecutive patients with AD, with or without CI, followed up regularly for more than 1 year.
MEASUREMENTS: The patients were classified according to the distribution and severity of CI as defined according to the NINDS‐AIREN neuroimaging criteria into those with AD and no CI (AD‐N), those with AD and CI not fulfilling neuroimaging criteria (AD‐I), and those with AD and CI fulfilling neuroimaging criteria (AD‐V), and their differences in dementia progression were tested. The loss of independence, indicated by institution admission or a clinical dementia rating (CDR) score of 3, was defined as the endpoint for a poor outcome.
RESULTS: The mean age was 75.8, and 68.5% were women. The initial Mini‐Mental State Examination (MMSE) score was 15.3±0.4, and the average duration of follow up was 30.4 months. Fifty‐four patients had reached study endpoint at the time of analysis. AD‐V (hazard ratio (HR)=3.1, 95% confidence interval (CI)=1.2–8.2), use of psychotropic drugs (HR=2.7, 95% CI=1.1–6.4), and initial MMSE score (HR=0.9, 95% CI=0.8–1.0) were independent predictors of poor outcome in the Cox regression model.
CONCLUSION: In AD, co‐occurrence of CI with distribution and severity as defined in the NINDS‐AIREN neuroimaging criteria for VaD is associated with faster dementia progression.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/j.1532-5415.2007.01171.x</identifier><identifier>PMID: 17537094</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Aged ; Alzheimer Disease - complications ; Alzheimer Disease - diagnostic imaging ; Alzheimer Disease - psychology ; Alzheimer's disease ; Biological and medical sciences ; cerebral infarction ; Cerebral Infarction - complications ; Cerebral Infarction - diagnostic imaging ; Cerebral Infarction - psychology ; Cohort Studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dementia ; Dementia, Vascular - diagnostic imaging ; Dementia, Vascular - etiology ; Disease Progression ; Female ; General aspects ; Humans ; Male ; Medical imaging ; Medical sciences ; Neurology ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Tomography, X-Ray Computed ; vascular dementia ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2007-06, Vol.55 (6), p.918-922</ispartof><rights>2007 INIST-CNRS</rights><rights>2007, The American Geriatrics Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3771-80016d633de083a2ed56344a74ec047e11648ef3fd4a3d3a17805d1bd7231e2a3</citedby><cites>FETCH-LOGICAL-c3771-80016d633de083a2ed56344a74ec047e11648ef3fd4a3d3a17805d1bd7231e2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1532-5415.2007.01171.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1532-5415.2007.01171.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18845932$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17537094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sheng, Bun</creatorcontrib><creatorcontrib>Cheng, Lik Fai</creatorcontrib><creatorcontrib>Law, Chun Bon</creatorcontrib><creatorcontrib>Li, Ho Lun</creatorcontrib><creatorcontrib>Yeung, Kwan Mo</creatorcontrib><creatorcontrib>Lau, Kwok Kwong</creatorcontrib><title>Coexisting Cerebral Infarction in Alzheimer's Disease Is Associated with Fast Dementia Progression: Applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>OBJECTIVES: To determine whether patients with Alzheimer's disease (AD) and coexisting cerebral infarction (CI) that satisfy the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS‐AIREN) neuroimaging criteria for vascular dementia (VaD) progress faster than those who do not satisfy the neuroimaging criteria.
DESIGN: Retrospective cohort study.
SETTING: Multidisciplinary memory clinic in a tertiary hospital.
PARTICIPANTS: One hundred thirty consecutive patients with AD, with or without CI, followed up regularly for more than 1 year.
MEASUREMENTS: The patients were classified according to the distribution and severity of CI as defined according to the NINDS‐AIREN neuroimaging criteria into those with AD and no CI (AD‐N), those with AD and CI not fulfilling neuroimaging criteria (AD‐I), and those with AD and CI fulfilling neuroimaging criteria (AD‐V), and their differences in dementia progression were tested. The loss of independence, indicated by institution admission or a clinical dementia rating (CDR) score of 3, was defined as the endpoint for a poor outcome.
RESULTS: The mean age was 75.8, and 68.5% were women. The initial Mini‐Mental State Examination (MMSE) score was 15.3±0.4, and the average duration of follow up was 30.4 months. Fifty‐four patients had reached study endpoint at the time of analysis. AD‐V (hazard ratio (HR)=3.1, 95% confidence interval (CI)=1.2–8.2), use of psychotropic drugs (HR=2.7, 95% CI=1.1–6.4), and initial MMSE score (HR=0.9, 95% CI=0.8–1.0) were independent predictors of poor outcome in the Cox regression model.
CONCLUSION: In AD, co‐occurrence of CI with distribution and severity as defined in the NINDS‐AIREN neuroimaging criteria for VaD is associated with faster dementia progression.</description><subject>Aged</subject><subject>Alzheimer Disease - complications</subject><subject>Alzheimer Disease - diagnostic imaging</subject><subject>Alzheimer Disease - psychology</subject><subject>Alzheimer's disease</subject><subject>Biological and medical sciences</subject><subject>cerebral infarction</subject><subject>Cerebral Infarction - complications</subject><subject>Cerebral Infarction - diagnostic imaging</subject><subject>Cerebral Infarction - psychology</subject><subject>Cohort Studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dementia</subject><subject>Dementia, Vascular - diagnostic imaging</subject><subject>Dementia, Vascular - etiology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Neurology</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>vascular dementia</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUtFu0zAUDQjESuEXkIUEe0pnx0nsIfFQZVspjILYELxZbnLTukvtYjtay9fjNGWTEEhYiuzI555z7vWJIkTwiIR1shqRjCZxlpJslGDMRpgQRkbbh9Hg7uJRNMAYJzHPSXoUPXVuhTFJMOdPoiPCMsrwaTp48KEwsFXOK71ABViYW9mgqa6lLb0yGimNxs3PJag12GOHzpQD6QBNHRo7Z0olPVToVvklupDOozNYg_ZKos_WLCw4FzjeoPFm0-w6Bb8ENJMd8V4lyPrWA6qNRTNorWnMQpXhKsgYW4F1SOoKXXlrbuDkt2Bna6o9WH1gArQxrUWNRF-gXIINHwKPmuNz7UAt9N4TAt1ruFKBLsH1f2otF_verQqMwfg_Gt63WBhdmrXyMtD9ZVjPose1bBw8P-zD6OvF-XXxLr78NJkW48u4pIyRmId3yKuc0gowpzKBKstpmkqWQolTBoTkKYea1lUqaUUlYRxnFZlXLKEEEkmH0eued2PNjxacF2vlSmgaqcG0TjCcsTQN6GH08g_gKgwqTMyJhGDKMh5cDCPeg8owG2ehFhsbpmJ3gmDRpU2sRBcq0YVKdGkT-7SJbSh9ceBv52uo7gsP8QqAVweAdOFdayt1qdw9jvM0O6Wd0bc97lY1sPtvA-L95Ko7hfq4rw9Jhu1dvbQ3ImehT_FtNhHX-UdCsoKL7_QXpAMGzA</recordid><startdate>200706</startdate><enddate>200706</enddate><creator>Sheng, Bun</creator><creator>Cheng, Lik Fai</creator><creator>Law, Chun Bon</creator><creator>Li, Ho Lun</creator><creator>Yeung, Kwan Mo</creator><creator>Lau, Kwok Kwong</creator><general>Blackwell Publishing Inc</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200706</creationdate><title>Coexisting Cerebral Infarction in Alzheimer's Disease Is Associated with Fast Dementia Progression: Applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction</title><author>Sheng, Bun ; Cheng, Lik Fai ; Law, Chun Bon ; Li, Ho Lun ; Yeung, Kwan Mo ; Lau, Kwok Kwong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3771-80016d633de083a2ed56344a74ec047e11648ef3fd4a3d3a17805d1bd7231e2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Alzheimer Disease - complications</topic><topic>Alzheimer Disease - diagnostic imaging</topic><topic>Alzheimer Disease - psychology</topic><topic>Alzheimer's disease</topic><topic>Biological and medical sciences</topic><topic>cerebral infarction</topic><topic>Cerebral Infarction - complications</topic><topic>Cerebral Infarction - diagnostic imaging</topic><topic>Cerebral Infarction - psychology</topic><topic>Cohort Studies</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Dementia</topic><topic>Dementia, Vascular - diagnostic imaging</topic><topic>Dementia, Vascular - etiology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>vascular dementia</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sheng, Bun</creatorcontrib><creatorcontrib>Cheng, Lik Fai</creatorcontrib><creatorcontrib>Law, Chun Bon</creatorcontrib><creatorcontrib>Li, Ho Lun</creatorcontrib><creatorcontrib>Yeung, Kwan Mo</creatorcontrib><creatorcontrib>Lau, Kwok Kwong</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sheng, Bun</au><au>Cheng, Lik Fai</au><au>Law, Chun Bon</au><au>Li, Ho Lun</au><au>Yeung, Kwan Mo</au><au>Lau, Kwok Kwong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coexisting Cerebral Infarction in Alzheimer's Disease Is Associated with Fast Dementia Progression: Applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2007-06</date><risdate>2007</risdate><volume>55</volume><issue>6</issue><spage>918</spage><epage>922</epage><pages>918-922</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>OBJECTIVES: To determine whether patients with Alzheimer's disease (AD) and coexisting cerebral infarction (CI) that satisfy the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS‐AIREN) neuroimaging criteria for vascular dementia (VaD) progress faster than those who do not satisfy the neuroimaging criteria.
DESIGN: Retrospective cohort study.
SETTING: Multidisciplinary memory clinic in a tertiary hospital.
PARTICIPANTS: One hundred thirty consecutive patients with AD, with or without CI, followed up regularly for more than 1 year.
MEASUREMENTS: The patients were classified according to the distribution and severity of CI as defined according to the NINDS‐AIREN neuroimaging criteria into those with AD and no CI (AD‐N), those with AD and CI not fulfilling neuroimaging criteria (AD‐I), and those with AD and CI fulfilling neuroimaging criteria (AD‐V), and their differences in dementia progression were tested. The loss of independence, indicated by institution admission or a clinical dementia rating (CDR) score of 3, was defined as the endpoint for a poor outcome.
RESULTS: The mean age was 75.8, and 68.5% were women. The initial Mini‐Mental State Examination (MMSE) score was 15.3±0.4, and the average duration of follow up was 30.4 months. Fifty‐four patients had reached study endpoint at the time of analysis. AD‐V (hazard ratio (HR)=3.1, 95% confidence interval (CI)=1.2–8.2), use of psychotropic drugs (HR=2.7, 95% CI=1.1–6.4), and initial MMSE score (HR=0.9, 95% CI=0.8–1.0) were independent predictors of poor outcome in the Cox regression model.
CONCLUSION: In AD, co‐occurrence of CI with distribution and severity as defined in the NINDS‐AIREN neuroimaging criteria for VaD is associated with faster dementia progression.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>17537094</pmid><doi>10.1111/j.1532-5415.2007.01171.x</doi><tpages>5</tpages></addata></record> |
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subjects | Aged Alzheimer Disease - complications Alzheimer Disease - diagnostic imaging Alzheimer Disease - psychology Alzheimer's disease Biological and medical sciences cerebral infarction Cerebral Infarction - complications Cerebral Infarction - diagnostic imaging Cerebral Infarction - psychology Cohort Studies Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Dementia Dementia, Vascular - diagnostic imaging Dementia, Vascular - etiology Disease Progression Female General aspects Humans Male Medical imaging Medical sciences Neurology Retrospective Studies Severity of Illness Index Time Factors Tomography, X-Ray Computed vascular dementia Vascular diseases and vascular malformations of the nervous system |
title | Coexisting Cerebral Infarction in Alzheimer's Disease Is Associated with Fast Dementia Progression: Applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction |
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