Open AccessPrediction of poor clinical outcome in vascular cognitive impairment: TRACE‐VCI study
Author(s) -
Boomsma Jooske M.F.,
Exalto Lieza G.,
Barkhof Frederik,
Chen Christopher L.H.,
Hilal Saima,
Leeuwis Anna E.,
Prins Niels D.,
Saridin Francis N.,
Scheltens Philip,
Teunissen Charlotte E.,
Verwer Jurre H.,
Weinstein Henry C.,
der Flier Wiesje M.,
Biessels Geert Jan
Publication year - 2020
Publication title -
alzheimer's and dementia: diagnosis, assessment and disease monitoring
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.497
H-Index - 37
ISSN - 2352-8729
DOI - 10.1002/dad2.12077
Subject(s) - clinical dementia rating , dementia , vascular dementia , medicine , cohort , hazard ratio , proportional hazards model , confidence interval , disease
Prognostication in memory clinic patients with vascular brain injury (eg possible vascular cognitive impairment [VCI]) is often uncertain. We created a risk score to predict poor clinical outcome. Methods Using data from two longitudinal cohorts of memory clinic patients with vascular brain injury without advanced dementia, we created (n = 707) and validated (n = 235) the risk score. Poor clinical outcome was defined as substantial cognitive decline (change of Clinical Dementia Rating ≥1 or institutionalization) or major vascular events or death. Twenty‐four candidate predictors were evaluated using Cox proportional hazard models. Results Age, clinical syndrome diagnosis, Disability Assessment for Dementia, Neuropsychiatric Inventory, and medial temporal lobe atrophy most strongly predicted poor outcome and constituted the risk score (C‐statistic 0.71; validation cohort 0.78). Of note, none of the vascular predictors were retained in this model. The 2‐year risk of poor outcome was 6.5% for the lowest (0‐5) and 55.4% for the highest sum scores (10‐13). Discussion This is the first, validated, prediction score for 2‐year clinical outcome of patients with possible VCI.