title: Determinants of vascular dementia in the Cardiovascular Health Cognition Study.
abstract: OBJECTIVE
  The authors evaluated 3,375 participants without dementia at the time of MRI in 1991 to 1994 over 5.7 years for incident dementia and type of dementia.
  
  
  METHODS
  Incidence of and risk factors for vascular dementia (VaD) were measured using both pre-MRI and modified State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC) post-MRI review and further classified Alzheimer disease (AD) by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.
  
  
  RESULTS
  Approximately 44% (213) of 480 incident dementia cases were classified as possible or probable VaD by ADDTC. The incidence of VaD increased with age and was greater in blacks than whites. Risk factors for VaD included age, Modified Mini-Mental State Examination, high white matter grade, number of MRI infarcts, ventricular size, and history of stroke.
  
  
  CONCLUSIONS
  Vascular disease in the brain is prevalent among incident dementia cases. There is a substantial overlap between cases classified as Alzheimer disease by Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association and vascular dementia (VaD) by modified State of California Alzheimer's Disease Diagnostic and Treatment Centers criteria. The substantial contribution of vascular disease would be missed without inclusion of MRI. Treatment of risk factors for VaD could have an important impact on incidence of dementia.
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA. KullerL@edc.pitt.edu
authors.forename: L H
authors.initials: LH
authors.lastname: Kuller
authors.forename: O L
authors.initials: OL
authors.lastname: Lopez
authors.forename: W J
authors.initials: WJ
authors.lastname: Jagust
authors.forename: J T
authors.initials: JT
authors.lastname: Becker
authors.forename: S T
authors.initials: ST
authors.lastname: DeKosky
authors.forename: C
authors.initials: C
authors.lastname: Lyketsos
authors.forename: C
authors.initials: C
authors.lastname: Kawas
authors.forename: J C S
authors.initials: JC
authors.lastname: Breitner
authors.forename: A
authors.initials: A
authors.lastname: Fitzpatrick
authors.forename: C
authors.initials: C
authors.lastname: Dulberg
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D002536:Cerebral Arteries / Q000473:pathology* / Q000503:physiopathology; D002544:Cerebral Infarction / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity / Q000639:trends; D015140:Dementia, Vascular / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009483:Neuropsychological Tests; D044469:Racial Groups; D012307:Risk Factors; D012737:Sex Factors