Comparison of the Alzheimer's Disease Assessment Scale Cognitive Subscale and the Vascular Dementia Assessment Scale in differentiating elderly individuals with different degrees of white matter changes. The LADIS Study.
OBJECTIVE
The Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog) is a widely used rating instrument. The Vascular Dementia Assessment Scale cognitive subscale (VADAS-cog) includes additional tests reflecting mental speed and executive functions. The objective of this study was to compare the results of the two scales among subjects with various degrees of white matter hyperintensities (WMHs).


METHODS
In the multicentre, multinational Leukoaraiosis and Disability in the Elderly (LADIS) study, 616 non-disabled subjects between the ages of 65 and 84 were examined using MRI, the ADAS-cog and VADAS-cog. The WMH rating from the MRI divided the patients into groups of mild (n = 280), moderate (n = 187) and severe (n = 149) degrees of change.


RESULTS
Covariance analysis controlling for the effect of age and education revealed that the ADAS-cog differentiated only the mild and severe WMH groups, while the differences between all three groups were highly significant with the VADAS-cog.


CONCLUSIONS
The VADAS-cog significantly differentiated between all the white matter groups. In comparison, the ADAS-cog differentiated only severe changes. Accordingly, the VADAS-cog may be a more sensitive endpoint in studies of patients with white matter load and vascular burden of the brain.
Ylikoski
Raija
R
Memory Research Unit, Department of Neurology, University of Helsinki, Helsinki, Finland. raija.ylikoski@hus.fi
Jokinen
Hanna
H
Andersen
Pia
P
Salonen
Oili
O
Madureira
Sofia
S
Ferro
Jose
J
Barkhof
Frederik
F
van der Flier
Wiesje
W
Schmidt
Reinhold
R
Fazekas
Franz
F
Scheltens
Philip
P
Waldemar
Gunhild
G
Salvadori
Emilia
E
Pantoni
Leonardo
L
Inzitari
Domenico
D
Erkinjuntti
Timo
T
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D001921:Brain / Q000473:pathology*; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049292:Leukoaraiosis / Q000175:diagnosis* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000502:physiology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011340:Problem Solving / Q000502:physiology; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D011930:Reaction Time / Q000502:physiology; D015203:Reproducibility of Results; D012153:Retention, Psychology / Q000502:physiology; D013223:Statistics as Topic; D014706:Verbal Learning / Q000502:physiology