The accuracy of early diagnosis and predictors of death in Alzheimer's disease and vascular dementia--a follow-up study

Acta Psychiatr Scand. 1991 Sep;84(3):277-82. doi: 10.1111/j.1600-0447.1991.tb03144.x.

Abstract

A total of 87 patients with mild or moderate degree of dementia of the Alzheimer type (AD) or vascular dementia (VD) was identified (DSM-III criteria), and their cognitive capacity was evaluated by means of rating scales and psychometric tests. Three years later 30 patients (34%) were dead. Significantly more VD than AD patients died. Eight of the survivors declined to participate in a follow-up study, and 1 patient was excluded by mistake. Of the survivors, 17 had indisputably suffered cognitive decline during the follow-up period (4 VD and 13 AD, 35%). In the case of 11 patients (2 VD and 9 AD) cognitive decline remained doubtful, and 20 patients (9 VD and 11 AD, 42%) underwent no intellectual deterioration during the follow-up period. The results underline the problems of early diagnosis of dementia according to DSM-III criteria. For both sexes a high ischemia score and a low body mass index predicted death. A low score on a verbal fluency test predicted death for men but not for women, and a high difference between systolic and diastolic blood pressure increased the risk of death for men but not for women.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / mortality*
  • Alzheimer Disease / psychology
  • Cause of Death*
  • Computer Simulation
  • Dementia, Vascular / diagnosis*
  • Dementia, Vascular / mortality*
  • Dementia, Vascular / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Status Schedule / statistics & numerical data
  • Middle Aged
  • Models, Statistical
  • Neuropsychological Tests / statistics & numerical data
  • Survival Rate