ABSTRACT
We identified 85 patients in a longitudinal study of dementia who had uncomplicated Alzheimer's disease and in whom computed tomography of the head and psychometric testing were conducted within a 6-month period following their entry into the study. Thirty-four patients (40%) had leukoaraiosis, which was disproportionately common in female patients (62% vs 15% in male patients). Analysis of covariance demonstrated a relative reduction of scores on the Extended Scale for Dementia in those patients who had leukoaraiosis, after adjusting for the confounding effects of age, sex, educational level, and duration of illness. Leukoaraiosis was also much more common in women, even after adjusting for the possible confounding effects of age, duration of illness, Extended Scale for Dementia score, and hypertension. Multiple regression analysis showed that leukoaraiosis accounted for 11.6% of the variance of the Extended Scale for Dementia scores. Leukoaraiosis, together with duration of illness, accounted for 18.2% of the variance. Leukoaraiosis is associated with a greater degree of cognitive impairment in patients with Alzheimer's disease.
Subject(s)
Alzheimer Disease/psychology , Brain Diseases/psychology , Cognition Disorders/diagnosis , Aged , Alzheimer Disease/complications , Brain/diagnostic imaging , Brain Diseases/complications , Cognition Disorders/complications , Female , Humans , Male , Psychometrics , Tomography, X-Ray ComputedABSTRACT
We report findings on a study of anxiety and depression by questionnaire in 50 patients with mild dementia and 134 control subjects using the Hospital Anxiety and Depression Scale. Thirty-eight percent of patients and 9% of controls had a possible or probable diagnosis of an anxiety disorder. Possible or probable depression was found in 28% of the patients and 3% of the controls. These rates for the patients were above those in normal populations. All patients and control subjects were tested with the Extended Scale for Dementia (ESD). Neither group showed a significant relationship between depression and ESD scores. In the control subjects there was a negative correlation (P less than .006) between anxiety and cognitive scores, one that was not found in the patients.
Subject(s)
Anxiety Disorders/epidemiology , Dementia/complications , Depressive Disorder/epidemiology , Aged , Aged, 80 and over , Anxiety Disorders/diagnosis , Anxiety Disorders/etiology , Depressive Disorder/diagnosis , Depressive Disorder/etiology , Diagnosis, Differential , Female , Hospitals, Psychiatric , Hospitals, University , Humans , Male , Middle Aged , Ontario , Prevalence , Psychiatric Status Rating Scales , Surveys and QuestionnairesABSTRACT
The Extended Scale for Dementia was introduced as a test for grading the intellectual function of patients with dementia. Its use in discriminating demented patients from nondemented control subjects has been explored. The test had a sensitivity of 93% and a specificity of 96% in patients over the age of 65 years, but the sensitivity fell to 75% in those younger than 65 years. The scale may be useful, particularly for patients over the age of 65 years, in helping to distinguish dementia from normality.
