Rethinking the dementia diagnoses in a population-based study:: What is Alzheimer's disease and what is vascular dementia?: A study from the Kungsholmen project

被引:53
作者
Agueero-Torres, Hedda
Kivipelto, Miia
von Strauss, Eva
机构
[1] Karolinska Inst, Aging Res Ctr, Neurotec, SE-11330 Stockholm, Sweden
[2] Karolinska Inst, Div Geriatr Epidemiol, Neurotec, SE-11330 Stockholm, Sweden
[3] Stockholm Gerontol Res Ctr, Stockholm, Sweden
关键词
aging; Alzheimer's disease; vascular dementia; mixed dementia; population-based study;
D O I
10.1159/000094973
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: To explore the hypothesis that older adults often are affected by more than one disease, making the differential diagnosis between Alzheimer's disease ( AD) and vascular dementia (VaD) difficult. Methods: Incident dementia cases (n = 308) from a population-based longitudinal study of people 75+ years were investigated. The DSM-III-R criteria were used for the clinical diagnosis of dementia. Data on vascular disorders ( hypertension, cerebrovascular and ischemic heart diseases, heart failure, atrial fibrillation, diabetes) as well as type of onset/course of dementia were used retrospectively to reclassify dementias. Results: Only 47% of the AD cases were reclassified as pure AD without any vascular disorder. Among subjects with AD and with a vascular component, cerebrovascular disease was the most common (41%). Only 25% of VaD were reclassified as pure VaD. Further, 26% of the pure AD subjects developed a vascular disorder in the following 3 years. Conclusions: Both vascular and degenerative mechanisms may often contribute to the expression of dementia among the elderly. Most of the AD cases have vascular involvements, and pure dementia types in very old subjects constitute only a minority of dementia cases. Copyright (C) 2006 S. Karger AG, Basel.
引用
收藏
页码:244 / 249
页数:6
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