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.
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.
Authors: Jesús de Pedro-Cuesta; Javier Virués-Ortega; Saturio Vega; Manuel Seijo-Martínez; Pedro Saz; Fernanda Rodríguez; Angel Rodríguez-Laso; Ramón Reñé; Susana Pérez de las Heras; Raimundo Mateos; Pablo Martínez-Martín; José María Manubens; Ignacio Mahillo-Fernandez; Secundino López-Pousa; Antonio Lobo; Jordi Llinàs Reglà; Jordi Gascón; Francisco José García; Manuel Fernández-Martínez; Raquel Boix; Félix Bermejo-Pareja; Alberto Bergareche; Julián Benito-León; Ana de Arce; José Luis del Barrio Journal: BMC Neurol Date: 2009-10-19 Impact factor: 2.474
Authors: Peter T Nelson; Gregory A Jicha; Frederick A Schmitt; Huaichen Liu; Daron G Davis; Marta S Mendiondo; Erin L Abner; William R Markesbery Journal: J Neuropathol Exp Neurol Date: 2007-12 Impact factor: 3.685
Authors: Peter T Nelson; Erin L Abner; Frederick A Schmitt; Richard J Kryscio; Gregory A Jicha; Charles D Smith; Daron G Davis; John W Poduska; Ela Patel; Marta S Mendiondo; William R Markesbery Journal: Brain Pathol Date: 2008-11-19 Impact factor: 6.508
Authors: Myron F Weiner; Carlos Marquez de la Plata; B A Julie Fields; Kyle B Womack; Roger N Rosenberg; Yun-Hua Gong; Bao-Xi Qu; Ramon Diaz-Arrastia; Linda S Hynan Journal: Curr Alzheimer Res Date: 2009-02 Impact factor: 3.498