Unequal distribution of cognitive deficits in vascular dementia--is this a valid criterion in the ICD-10?
OBJECTIVE
To investigate the appropriateness of the ICD-10 criterion for vascular dementia which requires unequal distribution of deficits between different domains of cognitive function.


METHODS
Cross-sectional comparative study.


METHODS
Referrals to a specialist memory clinic in Sheffield and a community sample of patients from a general practice population in Melton Mowbray.


METHODS
The CAMCOG part of the Cambridge mental disorders of the elderly examination (CAMDEX) was assessed for 131 Sheffield subjects and 396 Melton Mowbray subjects to examine both total variability and differences between individual subscale items. Depression was also examined as this was a potential confounding factor.


RESULTS
After adjustment for age, sex and depression scores, there were no significant differences between vascular dementia subjects and Alzheimer's disease subjects at either centre for total variability of cognitive deficits and little difference between diagnoses for individual subscale items. In Sheffield, subjects with vascular dementia had significantly higher depression scores compared to those with Alzheimer's disease.


CONCLUSIONS
The usefulness of the concept of unequal deficits as a diagnostic criterion for vascular dementia in routine clinical practice is doubtful.
Boston
P F
PF
Michael Carlisle Centre, Nether Edge Hospital, Sheffield, S11 9BJ, UK.
Dennis
M S
MS
Jagger
C
C
Jarman
M
M
Lamers
C
C
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D016011:Normal Distribution; D012189:Retrospective Studies; D006113:United Kingdom