Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-25T14:07:10.309Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of co-existent cerebrovascular disease on rate of progression in Alzheimer's disease

Published online by Cambridge University Press:  13 June 2014

Gregory RJ Swanwick ,
Michael Kirby ,
Robert F Coen ,
Conor P Maguire ,
Desmond O'Neill ,
Bernard J Walsh ,
Davis Coakley  and
Brian A Lawlor
Gregory RJ Swanwick
Affiliation:
Dept of Psychiatry of Old Age, 61 Eccles St, Dublin 2, Ireland
Michael Kirby
Affiliation:
St Vincent's Hospital, Elm Park, Dublin 4, Ireland
Brian A Lawlor
Affiliation:
Mercer's Institute for Research on Aging, St James's Hospital, Dublin 8, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The aim of this study was to determine whether patients with possible Alzheimer's disease (AD) who do not meet criteria for vascular dementia but who nonetheless have clinical or radiographic evidence of cerebrovascular disease (CVD), differ in presentation or rate of progression from patients with probable AD.

Method: Baseline cognitive and functional scores were obtained from 154 patients who had either possible or probable AD. Repeat data after a 12 month interval were obtained on 73 of these patients. Baseline data and rates of progression were compared for probable AD patients and possible AD patients with evidence of co-existent CVD.

Results: The diagnostic groups did not differ at baseline with a mean mini-mental state examination (MMSE) score of 18.1. Comparison of the longitudinal data showed a mean annual drop of 4.1 points on the MMSE in both groups.

Conclusions: The patients with and without evidence of co-existent CVD did not differ either at baseline or prognostically suggesting that evidence of CVD does not affect the rate of progression in AD. However, further longitudinal studies using neuropathological criteria are warranted to determine whether such data can be interpreted in favour of including possible AD cases in clinical trials of probable AD.

Keywords

Alzheimer's diseaseProgressionCerebrovascular disease
Type
Orginal Papers
Information
Irish Journal of Psychological Medicine , Volume 13 , Issue 3 , September 1996 , pp. 91 - 94
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Skoog, I, Nilsson, L, Palmertz, B, Andreasson, L-A, Svanborg, A. A population based study of dementia in 85 year olds. N Engl J Med 1993; 328: 153–8.CrossRefGoogle ScholarPubMed
2.Mann, UM, Mohr, E, Gearing, M, Chase, TN. Heterogeneity in Alzheimer's disease: progression rate segregated by distinct neuropsychological and cerebral metabolic profiles. J Neurol Neurosurg Psychiatry 1992; 55: 956–9.CrossRefGoogle ScholarPubMed
3.Galasko, D, Corey-Bloom, J, Thai, L. Monitoring progression in Alzheimer's disease. J Am Geriatr Soc 1991; 39: 932–941.CrossRefGoogle ScholarPubMed
4.Drachman, DA, O'Connell, BF, Lew, RA, Swearer, JM. The prognosis in Alzheimer's disease: ‘How far’ rather than ‘how fast’ best predicts the course. Arch Neurol 1990;47:851–6.CrossRefGoogle ScholarPubMed
5.Stern, RG, Mohs, RC, Davidson, M, et al.A longitudinal study of Alzheimer's disease: measurement, rate, and predictors of cognitive deterioration. Am J Psychiatry 1994; 151:390–6.Google ScholarPubMed
6.Burns, A, Jacoby, R, Levy, R. Progression of cognitive impairment in Alzheimer's disease. J Am Geriatr Soc 1991; 39: 39–45.CrossRefGoogle ScholarPubMed
7.Corey-Bloom, J, Galasko, D, Hofstetter, CR, Jackson, JE, Thai, L. Clinical features distinguishing large cohorts with possible AD, probable AD, and mixed dementia. J Am Geriatr Soc 1993; 41: 31–7.CrossRefGoogle ScholarPubMed
8.Rosen, J, Colantonio, A, Becker, JT, Lopez, OL, DeKosky, ST, Moss, HB. Effects of a history of heavy alcohol consumption on Alzheimer's disease. Br J Psychiatry 1993; 163: 358–63.CrossRefGoogle ScholarPubMed
9.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: 250–60.CrossRefGoogle ScholarPubMed
10.Chui, HC, Victoroff, JI, Margolin, D, Jagust, W, Shankle, R, Katzman, R. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology 1992; 42: 473–80.CrossRefGoogle ScholarPubMed
11.McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM. Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task force on Alzheimer's Disease. Neurology 1984; 34: 939–44.CrossRefGoogle ScholarPubMed
12.Swanwick, GRJ, Coen, RF, O'Mahony, D,et al.A memory clinic for the assessment of mild dementia. Ir Med J 1996; 89: 104–5.Google ScholarPubMed
13.Hachinski, VC, lliff, LD, Zilhka, E, et al.Cerebral blood flow in dementia. Arch Neurol 1975;32:632–7.CrossRefGoogle ScholarPubMed
14.Folstein, MF, Folstein, SE, McHugh, PR. ‘Mini-Mental State’: a practical method for grading the cognitive state of subjects for the clinician. J Psychiatr Res 1975; 12: 189–98.CrossRefGoogle Scholar
15.Roth, M, Tym, E, Mountjoy, CQ, et al.CAMDEX: A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986; 149: 698–709.CrossRefGoogle Scholar
16.Blessed, G, Tomlinson, BE, Roth, M. The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects. Br J Psychiatry 1968; 114: 797–811.CrossRefGoogle ScholarPubMed
17.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed - revised (DSMIIIR). Washington DC: American Psychiatric Association, 1987.Google Scholar
18.Marder, K, Richards, M, Bello, J, et al.Clinical correlates of Alzheimer's disease with and without silent radiographic abnormalities. Arch Neurol 1995; 52: 146–51.CrossRefGoogle ScholarPubMed
19.Burns, A, Jacoby, R, Levy, R. Progression of cognitive impairment in Alzheimer's disease. J Am Geriatr Soc 1991; 39: 39–45.CrossRefGoogle ScholarPubMed
20.Yesavage, JA, Poulsen, AB, Sheikh, J, Tanke, E. Rates of change of common measures of impairment in senile dementia of the Alzheimer type. Psychopharmacol Bull 1988; 24: 531–4.Google Scholar
21.Haupt, M, Kurz, A, Pollmann, S. Severity of symptoms and rate of progression in Alzheimer's disease: a comparison of cases with early and late onset. Dementia 1992; 3:21–4.Google Scholar
22.Mölsä, PK, Paljuärvi, L, Rinne, JO, Rinne, UK, Säkö, E. Validity of clinical diagnosis in dementia: a prospective clinicopathological study. J Neurol Neurosurg Psychiat 1985; 48: 1085–90.CrossRefGoogle ScholarPubMed
23.Wade, JPH, Mirsen, TR, Hachinski, VC, Fisman, M, Lau, C, Merskey, H. The clinical diagnosis of Alzheimer's disease. Arch Neurol 1937; 44: 24–9.CrossRefGoogle Scholar
24.Nussbaum, M, Treves, TA, Korczyn, AD. Evaluation of the Hachinski Ischemic Scale in a prospective study. Dementia 1992; 3: 10–4.Google Scholar