Hostname: page-component-669899f699-tpknm Total loading time: 0 Render date: 2025-05-04T08:42:00.972Z Has data issue: false hasContentIssue false
  • English
  • Français

Diagnosis of Vascular Dementia: Consortium of Canadian Centres for Clinical Cognitive Research Concensus Statement

Published online by Cambridge University Press:  18 September 2015

Kenneth Rockwood ,
Irma Parhad ,
Vladimir Hachinski ,
Timo Erkinjuntti ,
Barry Rewcastle ,
Andrew Kertesz ,
M. Robin Eastwood  and
Stephen Phillips
Kenneth Rockwood*
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
Irma Parhad
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
Vladimir Hachinski
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
Timo Erkinjuntti
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
Barry Rewcastle
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
Andrew Kertesz
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
M. Robin Eastwood
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
Stephen Phillips
Affiliation:
Consortium of Canadian Centres for Clinical Cognitive Research
*
Division of Geriatric Medicine. Dalhousie University, 1763 Robie Street. Halifax, Nova Scotia, Canada B3H 3G2
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Interest in vascular causes for cognitive impairment is increasing, in recognition that such causes are common, and possibly preventable. This has led to attempts to better define vascular dementia and its natural history. Several sets of criteria for the diagnosis of vascular dementia have been proposed. We provide a brief overview of the background to the initiation of a Canadian consensus conference, established by the Consortium of Canadian Centres for Clinical Cognitive Research (C5R) and report the conclusions reached at that conference. To date, no one set of criteria is demonstrably superior to another; we have therefore not endorsed any of the competing sets, nor have we recommended our own. Instead we suggest that empiric studies are required to establish valid criteria. A diagnostic checklist, which combines existing criteria and additional data, is attached for clinicians wishing to participate in such studies.

Résumé:

Résumé:

Diagnostic de la démence vasculaire: consensus du consortium des centres canadiens pour recherche clinique sur la cognition. L’intérêt pour les causes vasculaires des déficits cognitifs a augmenté depi que l’on sait que ces causes sont fréquentes et qu’on peut possiblement les prévenir. De là les efforts pour miei définir la démence vasculaire et décrire son évolution naturelle. Plusieurs séries de critères pour le diagnostic de démence vasculaire ont été proposées. Nous faisons un bref rappel du contexte dans lequel la conférence pour u consensus canadien, établie par le Consortium des centres canadiens pour la recherche clinique sur la cognition,; été amorcée et nous en rapportons les conclusions. Aucun ensemble de critères ne s’est avéré supérieur aux autres jusqu’à maintenant; nous n’en avons donc recommandé aucun, même pas le nôtre. Nous croyons que des études empiriques sont nécessaires pour établir des critères valides. Nous présentons une grille diagnostique incluant des critères actuels et des données additionelles à l’intention des cliniciens qui désirent participer à ces études.

Type
Neurological Diagnosis
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue 4 , November 1994 , pp. 358 - 364
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

References

REFERENCES

1. Hay, JW, Ernst, RL. The economic costs of Alzheimer’s disease. Am J Public Health 1987; 77: 1169–1175.Google Scholar
2. Erkinjuntti, T, Hachinski, V. Rethinking vascular dementia. Cerebrovasc Dis 1993; 3: 3–23.CrossRefGoogle Scholar
3. Hachinski, V. Preventable senility: a call for action against the vascular dementias. Lancet 1992; 340: 645–648.CrossRefGoogle Scholar
4. Jorm, AF. The Epidemiology of Alzheimer’s Disease and Related Disorders. London: Chapman and Hall, 1990.Google Scholar
5. Rocca, WA, Hofman, A, Brayne, C, et al. The prevalence of vascular dementia in Europe: facts and fragments from 1980–1990 studies. Ann Neurol 1990; 30: 817–824.CrossRefGoogle Scholar
6. Brust, JCM. Vascular dementia is overdiagnosed. Arch Neurol 1988; 45:799–801.Google Scholar
7. O’Brien, MD. Vascular dementia is underdiagnosed. Arch Neurol 1988; 45:797–798.CrossRefGoogle ScholarPubMed
8. Erkinjuntti, T, Haltia, Palo, J, Sulkava, R, Paetau, A. Accuracy of the clinical diagnosis of vascular dementia: a prospective clinical and post-mortem neuropathological study. J Neurol Neurosurg Psychiatry 1988; 51: 1037–1044.CrossRefGoogle ScholarPubMed
9. Phillips, S, Whisnant, JP. Hypertension and the brain. Arch Intern Med 1992; 152:938–945.Google Scholar
10. Tatemichi, TK. How acute brain failure becomes chronic: a view of the mechanisms of dementia related to stroke. Neurology 1990; 40: 1652–1659.CrossRefGoogle ScholarPubMed
11. Chui, HC, Victoroff, JI, Margolin, D, et al. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology 1992; 42:473–480.Google Scholar
12. Roman, GC, Tatemichi, TK, Erkinjuntti, T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993; 43: 250–260.Google Scholar
13. Drachman, DA. New criteria for the diagnosis of vascular dementia: do we know enough yet? Neurology 1993; 43: 243–245.CrossRefGoogle ScholarPubMed
14. Canadian Study of Health and Aging. The prevalence of dementia in Canada. Can Med Assoc J 1994; 150: 899–913.Google Scholar
15. Hachinski, V. The decline and resurgence of vascular dementia. Can Med Assoc J 1990; 142: 107–111.Google ScholarPubMed
16. Brust, JCM. Vascular dementia reconsidered. Cerebrovasc Dis 1993; 3:26.CrossRefGoogle Scholar
17. Eastwood, MR, Kennedy, JF. Geriatric Psychiatry Curr Opinion Psychiatry 1993: 6; 557–561.Google Scholar
18. Jorm, AF. A comparison of the ratio of Alzheimer’s disease to vascular dementia in various countries. Eur Arch Psychiatry Clin Neurosci 1991; 240:218–222.Google Scholar
19. Tatemichi, TK, Desmond, DW, Mayeux, R, et al. Dementia after stroke: baseline frequency, risks and clinical features in a hospitalized cohort. Neurology 1992; 42: 1185–1193.CrossRefGoogle Scholar
20. Marshall, J. Vascular dementias. In: Whitehouse, PJ, ed. Dementia Philadelphia: FA Davis, 1993.Google Scholar
21. Reaven, GM. Role of insulin resistance in human disease (syndrome X). Ann Rev Med 1993; 44: 121–131.CrossRefGoogle ScholarPubMed
22. Rimmer, JM, Gennari, FJ. Atherosclerotic renovascular disease and progressive renal failure. Ann Intern Med 1993; 118: 712–719.CrossRefGoogle ScholarPubMed
23. Brun, A, Englund, E. A white matter disorder in dementia of the Alzheimer type: a pathoanatomical study. Ann Neurol 1986; 19: 253–262.CrossRefGoogle Scholar
24. Olszewski, J. Subcortical arteriosclerotic encephalopathy: review of the literature of the so-called Binswanger’s disease, and presentation of two cases. World Neurol 1962; 3: 359–375.Google Scholar
25. Gray, F, Dubas, F, Roullet, E, Escourolle, R. Leukoencephalopathy in diffuse hemorrhagic cerebral amyloid angiopathy. Ann Neurol 1986; 18:54–59.CrossRefGoogle Scholar
26. Vinters, HV, Mah, VH. Vascular diseases. In: Duckett, S, ed. The Pathology of the Aging Human Nervous System Philadelphia: Lea&Febiger, 1991.Google Scholar
27. Hachinski, VC, Iliff, LD, Zilhka, E, et al. Cerebral blood now in dementia. Arch Neurol 1975; 32: 632–637.CrossRefGoogle Scholar
28. Rosen, WG, Terry, RD, Fould, PA, Katzman, R, Peck, A. Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 1980; 7: 486–488.CrossRefGoogle ScholarPubMed
29. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death. 9th Revision. Geneva: World Health Organization, 1976.Google Scholar
30. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death. 10th Revision. Geneva: World Health Organization, 1989. (Typescript document MNH/MEP/87.1, 25–31).Google Scholar
31. American Psychiatric Association. Diagnostic and Statistical Manual, 3rd ed. Washington: American Psychiatric Association, 1980.Google Scholar
32. American Psychiatric Association. Diagnostic and Statistical Manual, 3rd ed, Revised. Washington: American Psychiatric Association, 1987.Google Scholar
33. Roth, M, Huppert, FA, Tym, E, Mountjoy, CQ. (eds) CAMDEX: The Cambridge Examination for Mental Disorders of the Elderly Cambridge: Cambridge University Press, 1988.Google Scholar
34. Erkinjuntti, T, Sulkava, R. Diagnosis of multi-infarct dementia. Alzheimer Dis Assoc Dis 1991; 5: 112–121.CrossRefGoogle Scholar
35. Erkinjuntti, T, Laaksonen, R, Sulkava, R, Syrjalainen, R, Palo, J. Neuropsychological differentiation between normal aging, Alzheimer’s disease and vascular dementia. Acta Neurol Scand 1986; 74:393–403.Google Scholar
36. Roman, GC. Lacunar dementia. In: Senile Dementia of the Alzheimer Type. Alan R. Liss, 1985; 131–151.Google Scholar
37. Ishii, N, Nishihara, Y, Imamura, T. Why do frontal lobe symptoms predominate in vascular dementia with lacunes? Neurology 1986; 36:340–345.Google Scholar
38. Wolfe, N, Linn, R, Babikian, VL, Knoefel, JE, Albert, ML. Frontal systems impairment following multiple lacunar infarcts. Arch Neurol 1990; 47: 129–132.Google Scholar
39. Hougaku, H, Matsumoto, M, Kitagawa, K, et al. Silent cerebral infarction as a form of hypertensive target organ damage in the brain. Hypertension 1992; 20: 816–820.CrossRefGoogle ScholarPubMed
40. Kinkel, WR, Jacobs, L, Polachini, I, Bates, V, Heffner, RR Jr. Subcortical arteriosclerotic encephalopathy (Binswanger’s disease): computed tomographic, nuclear magnetic resonance, and clinical correlations. Arch Neurol 1985; 42: 951–959.CrossRefGoogle ScholarPubMed
41. Steingart, A, Hachinski, VC, Lau, C, et al. Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol 1987; 44: 32–35.CrossRefGoogle ScholarPubMed
42. Kertesz, A, Polk, M, Carr, T. Cognition and white matter changes on magnetic resonance imaging in dementia. Arch Neurol 1990; 47: 387–391.CrossRefGoogle ScholarPubMed
43. Rao, SM, Mittenberg, W, Bernardin, L, Haughton, V, Leo, GJ. Neuropsychological test findings in subjects with leukoaraiosis. Arch Neurol 1989; 46: 40–44.CrossRefGoogle ScholarPubMed
44. De Reuck, J, Crevits, L, De Coster, W, Sieben, G, vander Eecken, H. Pathogenesis of Binswanger chronic progressive subcortical encephalopathy. Neurology 1980; 30: 920–928.Google Scholar
45. Hunt, AL, Orrison, WW, Yeo, RA, et al. Clinical significance of MR1 white matter lesions in the elderly. Neurology 1989; 39: 1470–1474.CrossRefGoogle Scholar
46. Tupler, LA, Coffey, E, Logue, PE, Djang, WT, Fagan, SM. Neuropsychological importance of subcortical white matter hyperintensity. Arch Neurol 1992; 49: 1248–1252.Google Scholar
47. Brown, J, Hesselink, J, Rothrock, J. MR and CT of lacunar infarcts. Am J Neuroradiol 1988; 9: 477–482.Google Scholar
48. Tatemichi, TK, Foulkes, MA, Mohr, JP, et al. Dementia in stroke survivors in the Stroke Data Bank cohort. Prevalence, incidence, risk factors and computed tomographic findings. Stroke 1990; 21:858–866.CrossRefGoogle ScholarPubMed
49. Hachinski, VC, Potter, P, Merskey, H. Leuko-araiosis. Arch Neurol 1987; 44:21–23.CrossRefGoogle ScholarPubMed
50. Kobari, M, Meyer, J, Ichijo, M, Oravez, W. Leuko-araiosis: correlation of MR and CT findings with blood flow, atrophy and cognition. Am J Neuroradiol 1990; 11: 273–281.Google Scholar
51. Janota, I, Mirsen, TR, Hachinski, VC, Lee, DH, Merskey, H. Neuropathologic correlates of leuko-araiosis. Arch Neurol 1989; 46: 1124–1128.CrossRefGoogle ScholarPubMed
52. Leifer, D, Buonanno, FS, Richardson, EP Jr. Clinicopathologic correlations of cranial magnetic resonance imaging of periventricular white matter. Neurology 1990; 40: 911–918.CrossRefGoogle ScholarPubMed
53. Heinz, EK, Drayer, BP, Haenngeli, CA, et al. Computed tomography in white matter disease. Radiology 1979; 130: 371–378.Google Scholar
54. Lane, B, Carroll, BA, Pedley, TA. Computerized cranial tomography in cerebral disease of white matter. Neurology 1978; 28: 534–544.Google Scholar
55. Inzitari, D, Diaz, F, Fox, A, et al. Vascular risk factors and leukoaraiosis. Arch Neurol 1987; 44: 42–47.CrossRefGoogle ScholarPubMed
56. George, AJ, De Leon, MJ, Gentes, CI, et al. Leukoencephalopathy in normal and pathologic aging: 1. CT of brain lucencies. Am J Neuroradiol 1986; 7:561–566.Google Scholar
57. Kase, CS, Wolf, PA, Chodosh, EH, et al. Prevalence of silent stroke in patients presenting with initial stroke: The Framingham Study. Stroke 1989; 20:850–852.Google Scholar
58. Chodosh, EH, Foulkes, MA, Kase, CS, et al. Silent stroke in the NINCDS Stroke Data Bank. Neurology 1988; 38: 1674–1679.CrossRefGoogle ScholarPubMed
59. Skoog, I, Nilsson, L, Palmertz, B, Andreasson, L, Svanborg, A. A population-based study of dementia in 85-year-olds. N Engl J Med 1993; 328: 153–158.CrossRefGoogle ScholarPubMed
60. Hachinski, VC, Bowler, JV. Vascular dementia: diagnostic criteria for research studies. Neurology 1993; 43: 2159–2160.CrossRefGoogle Scholar