Overdiagnosing Vascular Dementia using Structural Brain Imaging for Dementia Work-Up

J Alzheimers Dis. 2015;45(4):1039-43. doi: 10.3233/JAD-142103.


Hypothesizing that non-significant cerebrovascular lesions on structural brain imaging lead to overdiagnosis of a vascular etiology of dementia as compared to autopsy-confirmed diagnosis, we set up a study including 71 patients with autopsy-confirmed diagnoses. Forty-two patients in the population (59%) appeared to have definite Alzheimer's disease (AD), whereas 29 (41%) had a non-AD dementia form. The panel clinically diagnosed possible or probable vascular dementia (VaD) in 27 (38%) patients, whereas only five (19%) patients (p = 0.017) had an autopsy-confirmed diagnosis of VaD. Patients with vascular lesions on structural brain imaging were often misdiagnosed as possible or probable VaD as compared to autopsy-confirmed diagnosis.

Keywords: Alzheimer's disease; brain imaging; dementia; differential dementia diagnosis; magnetic resonance imaging; vascular dementia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / pathology*
  • Brain / pathology*
  • Dementia, Vascular / diagnosis*
  • Dementia, Vascular / pathology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mental Status Schedule