Table 1 Diagnostic criteria of Alzheimer’s Disease (AD), Vascular Dementia (VaD), Mixed dementia (MD) and other dementias
Diagnosis | Criteria |
|---|---|
Development of multiple cognitive deficits, with both memory impairment and one (or more) of the following cognitive disturbances: | |
Aphasia (language disturbance) | |
Apraxia (learned motor skills disturbance) | |
Agnosia (visuospatial/sensory disturbance) | |
Executive functioning (foresight, planning, insight anticipation) | |
Significant impairment in social or occupational functioning, representing a significant decline from a previous level of functioning | |
Other diagnostic criteria: Hachinski Ischemic Score, ICD-10; DSM-IV; ADDTC; updated NINCDS-ADRDA | |
Vascular Dementia (VaD) (NINDS-AIREN) Source[13]: | Cognitive decline from previous higher level of function in three areas of function including memory. |
Evidence of cerebrovascular disease by examination | |
Evidence of cerebrovascular disease by neuroimaging | |
Onset either abrupt or within three months of a recognized stroke. | |
Vascular Dementia (VaD) (Modified Hachinski Ischemia Score: ≥4) Source[14]: | Two-point items |
Abrupt onset | |
History of stroke | |
Focal neurologic symptoms | |
One-point items | |
Stepwise deterioration | |
Somatic complaints | |
History of hypertension | |
Emotional incontinence | |
Other diagnostic criteria: ICD-10; DSM-IV | |
Mixed Dementias (MDs) | |
Hachinski Ischemic score | Score based on clinical features: ≤4 = AD; ≥7 = VaD; intermediate score of 5 or 6 = MD. |
ICD-10 | Cases that met criteria for VaD and AD |
DSM-IV | Cases with criteria for primary degenerative dementia of the Alzheimer type and clinical or neuroimagery feature of VaD. |
ADDTC | Presence of ischemic vascular disease and a second systemic or brain disorder. |
NINDS-AIREN | Typical AD associated with clinical and radiological evidence of stroke. |
Other Dementias | |
Fronto-Parietal Dementia (FTD) Source[15]: | Behavioral or cognitive deficits manifested by either (1) or (2): |
(1) Early and progressive personality change, with problems in modulating behavior; inappropriate responses/activities. | |
(2) Early and progressive language changes, with problems in language expression, word meaning, severe dysnomia. | |
Deficits represent a decline from baseline and cause significant impairment in social and occupational functioning. | |
Course characterized by gradual onset and continuing decline in function. | |
Other causes (eg, stroke, delirium) are excluded | |
Gradual onset and progressive cognitive decline. | |
Dementia with Lewy Bodies (DLB) (Consensus Guidelines for the Clinical Diagnosis for Dementia with Lewy Bodies) Source[16]: | Fluctuating in cognitive performance: Marked variation in cognition or function, or episodic confusion/decreased responsiveness. |
Visual hallucinations: Usually well formed, unprovoked, benign. | |
Parkinsonism: Can be identical to Parkinson’s Disease (PD), milder or symmetric. | |
Parkinson’s Disease with Dementia (PD-D) Source[17]: | Bradyphrenia (slowness of thought) |
Executive impairment | |
Neuropsychiatric symptoms | |
Dysphonia |