The accuracy of early diagnosis and predictors of death in Alzheimer's disease and vascular dementia--a follow-up study.
A total of 87 patients with mild or moderate degree of dementia of the Alzheimer type (AD) or vascular dementia (VD) was identified (DSM-III criteria), and their cognitive capacity was evaluated by means of rating scales and psychometric tests. Three years later 30 patients (34%) were dead. Significantly more VD than AD patients died. Eight of the survivors declined to participate in a follow-up study, and 1 patient was excluded by mistake. Of the survivors, 17 had indisputably suffered cognitive decline during the follow-up period (4 VD and 13 AD, 35%). In the case of 11 patients (2 VD and 9 AD) cognitive decline remained doubtful, and 20 patients (9 VD and 11 AD, 42%) underwent no intellectual deterioration during the follow-up period. The results underline the problems of early diagnosis of dementia according to DSM-III criteria. For both sexes a high ischemia score and a low body mass index predicted death. A low score on a verbal fluency test predicted death for men but not for women, and a high difference between systolic and diastolic blood pressure increased the risk of death for men but not for women.
Nielsen
H
H
Department of Neurology, Odense University Hospital, Denmark.
Lolk
A
A
Pedersen
I
I
Autzen
M
M
Sennef
C
C
Kragh-Sørensen
P
P
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D002423:Cause of Death; D003198:Computer Simulation; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D015233:Models, Statistical; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D015996:Survival Rate