What contribution can the Hachinski Ischemic Scale make to the differential diagnosis between multi-infarct dementia and primary degenerative dementia?
Five research studies in which clinical diagnoses using the Hachinski Ischemic Scale (HIS) underwent neuropathological verification were analysed. These studies reveal that the HIS differentiates between multi-infarct dementia (MID) and dementia of the Alzheimer type (DAT) with only limited accuracy. To some extent, there are considerable differences between the studies as regards the methodology and the patient population. However, there are indications that some items of the ischemic scale clearly distinguish between MID and DAT, whereas others hardly do so or some do not distinguish at all between these two conditions. If the HIS is revised according to the present findings, it can become a more valid differential diagnostic instrument. Such a diagnostic instrument which may be applied without any other technical equipment is required today, since epidemiological data and demographic prognoses show that the prevalence of dementing illnesses will markedly increase in the future.
Gräsel
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Department of Medical Psychology and Psychopathometry, University of Erlangen-Nürnberg, D-8520 Erlangen, FRG.
Cameron
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Lehrl
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