ABSTRACT
BACKGROUND: The validity ofHachinski Ischemic Score (HIS) in differentiating between Alzheimer's disease (AD) and Vascular dementia (VaD) has been questioned and compared with the gold standard autopsy. OBJECTIVE: To confirm that the HIS can be used to differentiate related VaD from AD in a Thai population. MATERIAL AND METHOD: A prospective study of 398 patients who were attending the Memory Clinic, at Siriraj Hospital between January 2001 and October 2003. RESULTS: The 214 patients, with a mean age of 71.15 + 10.20 years, were classified as AD, VaD or mixed dementia (AD with cerebrovascular disease) in proportion of 60.2%, 30.4%, and 9.3% respectively. The authors propose HIS at 5 as a cut off point to differentiate patients with AD and those with VaD or AD with cerebrovascular disease with sensitivity of 85.3% and specificity of 72.9%. CONCLUSION: The HIS can be applied to differentiate dementia related vascular etiology from AD in a Thai population.
Subject(s)
Aged , Aged, 80 and over , Alzheimer Disease/diagnosis , Dementia, Vascular/diagnosis , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Prospective Studies , Sensitivity and Specificity , ThailandABSTRACT
OBJECTIVE: The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Technitium L, L-ethyl cysteinate dimer Single Photon Emission Computer Tomography (99-Tc ECD SPECT) between mild and moderate to severe dementia. MATERIAL AND METHOD: The authors reported a retrospective study in the Memory Clinic, Siriraj Hospital between January 2001 and October 2003 including only patients with Alzheimer's disease, vascular dementia, and mixed dementia. Clinical dementia rating (CDR) was used to document dementia severity. Patterns of hypoperfusion were classified into no definite hypoperfusion, regional hypoperfusion, and diffused hypoperfusion. RESULTS: One hundred and seven patients were included in the present study. Only mean Thai Mental State Examination (TMSE) score was different between the two groups. There was no significant correlation between pattern of hypoperfusion in brain SPECT and severity of dementia. CONCLUSION: The authors cannot demonstrate the pattern of hypoperfusion of 99-Tc ECD SPECT among patients' difference in dementia severity.