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Unequal distribution of cognitive deficits in vascular dementia – is this a valid criterion in the ICD‐10?
Author(s) -
Boston Paul F.,
Dennis Michael S.,
Jagger Carol,
Jarman Maria,
Lamers Carolien
Publication year - 2001
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.357
Subject(s) - dementia , confounding , vascular dementia , depression (economics) , psychology , cognition , population , disease , cognitive disorder , medical diagnosis , alzheimer's disease , clinical psychology , medicine , psychiatry , pathology , environmental health , economics , macroeconomics
Objective To investigate the appropriateness of the ICD‐10 criterion for vascular dementia which requires unequal distribution of deficits between different domains of cognitive function. Design Cross‐sectional comparative study. Setting Referrals to a specialist memory clinic in Sheffield and a community sample of patients from a general practice population in Melton Mowbray. Method The CAMCOG part of the Cambridge mental disorders of the elderly examination (CAMDEX) was assessed for 131 Sheffield subjects and 396 Melton Mowbray subjects to examine both total variability and differences between individual subscale items. Depression was also examined as this was a potential confounding factor. Results After adjustment for age, sex and depression scores, there were no significant differences between vascular dementia subjects and Alzheimer's disease subjects at either centre for total variability of cognitive deficits and little difference between diagnoses for individual subscale items. In Sheffield, subjects with vascular dementia had significantly higher depression scores compared to those with Alzheimer's disease. Conclusions The usefulness of the concept of unequal deficits as a diagnostic criterion for vascular dementia in routine clinical practice is doubtful. Copyright © 2001 John Wiley & Sons, Ltd.