Dementia in patients with atrial fibrillation and the value of the Hachinski ischemic score.

Di Nisio, Marcello; Prisciandaro, Michele; Rutjes, Anne WS; Russi, Ilaria; Maiorini, Luisa; Porreca, Ettore (2015). Dementia in patients with atrial fibrillation and the value of the Hachinski ischemic score. Geriatrics and gerontology international, 15(6), pp. 770-777. Japan Geriatrics Society 10.1111/ggi.12349

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AIM To assess the prevalence of vascular dementia, mixed dementia and Alzheimer's disease in patients with atrial fibrillation, and to evaluate the accuracy of the Hachinski ischemic score for these subtypes of dementia. METHODS A nested case-control study was carried out. A total of 103 of 784 consecutive patients evaluated for cognitive status at the Ambulatory Geriatric Clinic had a diagnosis of atrial fibrillation. Controls without atrial fibrillation were randomly selected from the remaining 681 patients using a 1:2 matching for sex, age and education. RESULTS The prevalence of vascular dementia was twofold in patients with atrial fibrillation compared with controls (21.4% vs 10.7%, P = 0.024). Alzheimer's disease was also more frequent in the group with atrial fibrillation (12.6% vs 7.3%, P = 0.046), whereas mixed dementia had a similar distribution. The Hachinski ischemic score poorly discriminated between dementia subtypes, with misclassification rates between 46% (95% CI 28-66) and 70% (95% CI 55-83). In patients with atrial fibrillation, these rates ranged from 55% (95% CI 32-77) to 69% (95% CI 39-91%). In patients in whom the diagnosis of dementia was excluded, the Hachinski ischemic score suggested the presence of vascular dementia in 11% and mixed dementia in 30%. CONCLUSIONS Vascular dementia and Alzheimer's disease, but not mixed dementia, are more prevalent in patients with atrial fibrillation. The discriminative accuracy of the Hachinski ischemic score for dementia subtypes in atrial fibrillation is poor, with a significant proportion of misclassifications.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Rutjes, Anne

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1447-0594

Publisher:

Japan Geriatrics Society

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

10 Nov 2014 10:19

Last Modified:

20 Feb 2016 21:57

Publisher DOI:

10.1111/ggi.12349

PubMed ID:

25311856

Uncontrolled Keywords:

Hachinski ischemic score, atrial fibrillation, dementia

BORIS DOI:

10.7892/boris.59960

URI:

https://boris.unibe.ch/id/eprint/59960

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