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CT brain findings in clinical dementia investigation--underestimation of mixed dementia

Nägga, Katarina LU ; Radberg, Claes and Marcusson, Jan (2004) In Dementia and Geriatric Cognitive Disorders 18(1). p.59-66
Abstract
Dementia has been found to display a more heterogeneous clinical picture than previously recognized. We investigated brain changes on computed tomography (CT) in a clinical dementia population consisting of 67 cases with Alzheimer's disease (AD), 13 with mixed dementia (AD and vascular dementia, VaD), 71 with VaD, and 12 cases that were not demented. Temporal cortical atrophy and atrophy around the temporal horns were more common in patients with mixed dementia compared to patients with VaD and the non-demented, respectively. Frontal white matter changes were present in 64% of AD, in 85% of mixed dementia and in 79% of VaD cases, but there were no differences between the dementia groups. Lacunes were present in almost 40% of AD cases and... (More)
Dementia has been found to display a more heterogeneous clinical picture than previously recognized. We investigated brain changes on computed tomography (CT) in a clinical dementia population consisting of 67 cases with Alzheimer's disease (AD), 13 with mixed dementia (AD and vascular dementia, VaD), 71 with VaD, and 12 cases that were not demented. Temporal cortical atrophy and atrophy around the temporal horns were more common in patients with mixed dementia compared to patients with VaD and the non-demented, respectively. Frontal white matter changes were present in 64% of AD, in 85% of mixed dementia and in 79% of VaD cases, but there were no differences between the dementia groups. Lacunes were present in almost 40% of AD cases and in 80 and 85% of VaD and mixed dementia cases, respectively. Only 14% of the VaD cases had large infarcts on the CT. We conclude that large infarcts were rare, even in VaD cases. The increased incidence of white matter changes and lacunes in AD patients strongly indicates an underestimation of the mixed dementia diagnosis. More distinct criteria for this diagnostic category are warranted. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Dementia and Geriatric Cognitive Disorders
volume
18
issue
1
pages
59 - 66
publisher
Karger
external identifiers
  • wos:000221941400010
  • scopus:3042645082
ISSN
1420-8008
DOI
10.1159/000077737
language
English
LU publication?
no
id
33b8d278-6c42-4208-908f-2f4beab57914 (old id 1297859)
date added to LUP
2009-07-14 08:25:55
date last changed
2017-01-01 05:07:13
@article{33b8d278-6c42-4208-908f-2f4beab57914,
  abstract     = {Dementia has been found to display a more heterogeneous clinical picture than previously recognized. We investigated brain changes on computed tomography (CT) in a clinical dementia population consisting of 67 cases with Alzheimer's disease (AD), 13 with mixed dementia (AD and vascular dementia, VaD), 71 with VaD, and 12 cases that were not demented. Temporal cortical atrophy and atrophy around the temporal horns were more common in patients with mixed dementia compared to patients with VaD and the non-demented, respectively. Frontal white matter changes were present in 64% of AD, in 85% of mixed dementia and in 79% of VaD cases, but there were no differences between the dementia groups. Lacunes were present in almost 40% of AD cases and in 80 and 85% of VaD and mixed dementia cases, respectively. Only 14% of the VaD cases had large infarcts on the CT. We conclude that large infarcts were rare, even in VaD cases. The increased incidence of white matter changes and lacunes in AD patients strongly indicates an underestimation of the mixed dementia diagnosis. More distinct criteria for this diagnostic category are warranted.},
  author       = {Nägga, Katarina and Radberg, Claes and Marcusson, Jan},
  issn         = {1420-8008},
  language     = {eng},
  number       = {1},
  pages        = {59--66},
  publisher    = {Karger},
  series       = {Dementia and Geriatric Cognitive Disorders},
  title        = {CT brain findings in clinical dementia investigation--underestimation of mixed dementia},
  url          = {http://dx.doi.org/10.1159/000077737},
  volume       = {18},
  year         = {2004},
}