Skip to main content
Log in

Clinical evaluation of the ICD-10 criteria for vascular dementia

  • Original Articles
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Summary

The clinical feasibility of the ICD-10 criteria for subtypes of vascular dementia were examined in an investigation of 61 demented patients (74.4, SD 8.2 years) showing CT appearances of vascular lesions. Only 15 cases (24.6%) fulfilled the ICD-10 criteria of vascular dementia. Of these cases, 66.6% could adequately be classified in subtypes. The most frequent types of vascular dementia were multi-infarct dementia and subcortical vascular dementia. Our findings suggest that the ICD-10 criteria of vascular dementia are more selective than the classical ‘ischaemic scales’.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Alafuzoff I, Iqbal K, Friden H, Adolfsson R, Winblad B (1987) Histopathological criteria for progressive dementia disorders: clinical-pathological correlation and classification by multivariate data analysis. Acta Neuropathol (Berl) 74:209–225

    Google Scholar 

  2. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn, revised (DSM-III-R). American Psychiatric Association. Washington, DC, pp 103–123

    Google Scholar 

  3. Awad IA, Johnson PC, Spetzler RF, Hodak JA (1986) Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. II. Postmortem pathological correlations. Stroke 17:1090–1097

    Google Scholar 

  4. Babikian VL, Wolfe N, Linn R, Knoefel JE, Albert ML (1990) Cognitive changes in patients with multiple cerebral infarcts. Stroke 21:1013–1018

    Google Scholar 

  5. Bamford JM, Sanderock P, Jones L, Warlow CP (1987) The natural history of lacunar infarction: the Oxfordshire community stroke project. Stroke 18:545–551

    Google Scholar 

  6. Bennett DA, Wilson RS, Gilley DW, Fox JH (1990) Clinical diagnosis of Binswanger's disease. J Neurol Neurosurg Psychiatry 53:961–965

    Google Scholar 

  7. Blennow K, Wallin A, Uhlemann C, Gottfries CG (1991) White-matter lesions on CT in Alzheimer patients: relation to clinical symptomatology and vascular factors. Acta Neurol Scand 83:187–193

    Google Scholar 

  8. Blessed G, Tomlinson BE, Roth M (1968) The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 114:797–811

    Google Scholar 

  9. Bogousslavsky J, Regli F (1986) Unilateral watershed cerebral infarcts. Neurology 36:373–377

    Google Scholar 

  10. Braffman BH, Zimmermann RA, Trojanowski JQ, Gonatas NK, Hickey WF, Schlaepfer WW (1988) Brain MR: pathologic correlation with gross and histopathology. 2. Hypertensive white-matter foci in the elderly. AJR 151:559–566

    Google Scholar 

  11. Braffman BH, Zimmermann RA, Trojanowski JQ, Gonatas NK, Hickey WF, Schlaepfer WW (1988) Brain MR: pathologic correlation with gross and histopathology. 1. Lacunar infarction and Virchow-Robin spaces, AJR 151:551–558

    Google Scholar 

  12. Brun A, Gustafson L (1988) Zerebrovaskuläre Erkrankungen. In: Kisker KP, Lauter H, Meyer JE, Müller E, Strömgren E (eds) Psychiatrie der Gegenwart, 6, 3rd edn. Springer, Berlin Heidelberg New York, pp 253–295

    Google Scholar 

  13. Cohen MB, Graham LS, Lake R, Metter EJ, Fitten J, Kulkarni MK, Sevrin R, Yamada L, Chang CC, Woodruff N, Kling AS (1986) Diagnosis of Alzheimer's disease and multiple infarct dementias by tomographic imaging of Iodine-123 IMP. J Nucl Med 27:769–774

    Google Scholar 

  14. Constanfinidis J, Krassoievitch M, Tissot R (1969) Correlations entre les perturbations electroencephalographiques et les lesions anatomo-histologiques dans les demences. Encephale 58:19–52

    Google Scholar 

  15. Cummings JL (1987) Multi-infarct dementia: diagnosis and management. Psychosomatics 28:117–126

    Google Scholar 

  16. Deutsch G, Tweedy JR (1987) Cerebral blood flow in severity-matched Alzheimer and multi-infarct patients. Neurology 37: 431–438

    Google Scholar 

  17. DeWitt LD, Kistler JP, Miller DC, Richardson EP, Buonanno FS (1987) NMR neuropathological correlation in stroke. Stroke 18:342–351

    Google Scholar 

  18. Dougherty JH, Simmonds H, Parker J (1986) Subcortical ischemic disease. Clinical spectrum and MRI correlation. Stroke 17:146

    Google Scholar 

  19. Dyken ML, Wolf PA, Barnett HJM, Bergan JJ, Hass WK, Kannel WB, Kuller L, Kurtzke JF, Sundt TM (1984) Risk factors in stroke. Stroke 15:1105–1111

    Google Scholar 

  20. Englund E, Brun A, Alling A (1988) White matter changes in dementia of Alzheimer's type. Brain 111:1425–1439

    Google Scholar 

  21. Erkinjuntti T (1987) Types of multi-infarct dementia. Acta Neurol Scand 75:391–399

    Google Scholar 

  22. Erkinuntti T (1987) Differential diagnosis between Alzheimer's disease and vascular dementia: evaluation of common clinical methods. Acta Neurol Scand 76:433–442

    Google Scholar 

  23. Erkinjuntti T, Larsen T, Sulkava R, Ketonen L, Laaksonen R, Palo J (1987) EEG in the differential diagnosis between Alzheimer's disease and vascular dementia. Acta Neurol Scand 77:36–43

    Google Scholar 

  24. Erkinjuntti T, Ketonen L, Sulkava R, Sipponen J, Vuorialho M, Iivanainen M (1987) Do white matter changes on MRI and CT differentiate vascular dementia for Alzheimer's disease. J Neurol Neurosurg Psychiatry 50:37–42

    Google Scholar 

  25. Erkinjuntti T, Haltia M, Palo J, Sulkava R, Paetau A (1988) Accuracy of the clinical diagnosis of vascular dementia: a prospective clinical and post-mortem neuropathological study. J Neurol Neurosurg Psychiatry 51:1037–1044

    Google Scholar 

  26. Folstein M, Folstein S, Mc Hugh PR (1975) Mini-Mental state: A practical for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–192

    Google Scholar 

  27. George AE, Leon MJ de, Kalnin A, Rosner L, Goodgold A, Chase N (1986) Leucoencephalopathy in normal and pathologic ageing. 2. MRI of brain lucencies. AJNR 7:567–570

    Google Scholar 

  28. Goldenberg G, Samec P (1981) Zur Differentialdiagnose vaskulärbedingter dementieller Syndrome. Nervenarzt 52:405–414

    Google Scholar 

  29. Hachinski VC, Lassen NA, Marshall J (1974) Multi-infarct dementia. A cause of mental deterioration in the elderly. Lancet II:207–210

    Google Scholar 

  30. Hachinski VC, Illif LD, Zilhka E, du Boulay GH, Mc Allister VL, Marshall J, Russell RWR, Symon L (1975) Cerebral blood flow in dementia. Arch Neurol 32:632–637

    Google Scholar 

  31. Hachinski VC, Potter P, Meskey H (1987) Leuko Araiosis. Arch Neurol 44:21–23

    Google Scholar 

  32. Heiss W-D, Herholz K, Pawlik G, Szelies B (1988) Beitrag der Positronen-Emissions-Tomographie zur Diagnose der Demenz. Dtsch Med Wochenschr 113:1362–1367

    Google Scholar 

  33. Jagust WJ, Budinger TF, Reed BR (1987) The diagnosis of dementia with single photon emission computed tomography. Arch Neurol 44:258–262

    Google Scholar 

  34. Jellinger K, Danielczyk W, Fischer P, Gabriel E (1990) Clinico-pathological analysis of dementia disorders in the elderly. J Neurol Sci 95:239–258

    Google Scholar 

  35. Jorm AF (1991) Cross-national comparisons of the occurrence of Alzheimer's disease and vascular dementias. Eur Arch Psychiatry Clin Neurosci 240:218–222

    Google Scholar 

  36. Junque C, Pujol J, Vendrell P, Bruna O, Jodar M, Ribas JC, Vinas J, Capdevila A, Marti-Vilalta JL (1990) Leuko-araiosis on magnetic resonance imaging and speed of mental processing. Arch Neurol 47:151–156

    Google Scholar 

  37. Kertesz A, Black SE, Nicholson L, Carr T (1987) The sensitivity and specificity of MRI in stroke. Neurology 37:1580–1585

    Google Scholar 

  38. Kinkel WR, Jacobs L, Polachini I, Bates V, Heffner RR (1985) Subcortical arteriosclerotic encephalopathy (Binswanger's disease). Arch Neurol 42:951–959

    Google Scholar 

  39. Kozachuk WE, DeCarli C, Schapiro MB, Wagner EE, Rapoport SI, Horwitz B (1990) White matter hyperintensities in dementia of Alzheimer's type and in healthy subjects with-out cerebrovascular risk factors. Arch Neurol 47:1306–1310

    Google Scholar 

  40. Ladurner G, Iliff LD, Sager WD, Lechner H (1982) A clinical approach to vascular (multiinfarct) dementia. Exp Brain Res [Suppl 5]:243–250

    Google Scholar 

  41. Loeb C (1988) Clinical criteria for the diagnosis of vascular dementia. Eur Neurol 28:87–92

    Google Scholar 

  42. Loeb C (1989) The lacunar syndromes. Eur Neurol 29 [Suppl 2]: 2–7

    Google Scholar 

  43. Loeb C, Gandolfo C (1983) Diagnostic evaluation of degenerative and vascular dementia. Stroke 14:399–401

    Google Scholar 

  44. Loeb C, Gandolfo C, Bino G (1988) Intellectual impairment and cerebral lesions in multiple cerebral infarcts. Stroke 19: 560–565

    Google Scholar 

  45. Loizou LA, Jefferson JM, Smith WT (1982) Subcortical arteriosclerotic encephalopathy (Binswanger's type) and cortical infarcts in a young normotensive patient. J Neurol Neurosurg Psychiatry 45:409–417

    Google Scholar 

  46. Malamud N (1972) Neuropathology of organic brain syndromes associated with aging. In: Gaitz CM (ed) Aging and the brain. Plenum Press, New York, pp 63–87

    Google Scholar 

  47. Marshall VG, Bradley WG, Marshall CE, Bhoopat T, Rhodes RH (1988) Deep white matter infarction: correlation of MR imaging and histopathologic findings. Radiology 167:517–522

    Google Scholar 

  48. Meyer JS, McClintic KL, Rogers RL, Sims P, Mortel KF (1988) Aetiological considerations and risk factors for multiinfarct dementia. J Neurol Neurosurg Psychiatry 51:1489–1497

    Google Scholar 

  49. Mölsa PK, Mattila FJ, Rinne UK (1982) Epidemiology of dementia in a Finnish population. Acta Neurol Scand 65:541–552

    Google Scholar 

  50. Müller HF, Schwartz G (1978) Electroencephalograms and autopsy findings in geropsychiatry. J Gerontol 33:504–513

    Google Scholar 

  51. Müller M, Schreiner R, Bayer B (1989) Halsgefäßsonographie. Stellenwert in der Differentialdiagnose dementieller Syndrome. Fortschr Med 107:733–735

    Google Scholar 

  52. Parnetti L, Mecocci P, Santucci C, Gaiti A, Petrini A, Longo A, Cadini D, Caputo N, Signorini E, Senin U (1990) Is multiinfarct dementia representative of vascular dementias? A retrospective study. Acta Neurol Scand 81:484–487

    Google Scholar 

  53. Poeck K (1989) Chronische vaskuläre Enzephalopathie. Dtsch Med Wochenschr 114:1582–1587

    Google Scholar 

  54. Reiche W, Weiller C, Büll U, Kaiser HJ, Kersting A, Ringelstein EB (1990) Bestimmung der regionalen, zerebrovaskulären Perfusionsreserve (rCRP) mit der quantitativen Fluß/Volumen (F/V)-SPECT. Fortschr Röntgenstr 153:36–40

    Google Scholar 

  55. Rezek DL, Morris JC, Fulling KH, Gado MH (1987) Periventricular white matter lucencies in senile dementia of the Alzheimer type. Arch Neurol 44:1030–1032

    Google Scholar 

  56. Ringelstein EB, Zeumer H, Schneider R (1985) Der Beitrag der zerebralen Computertomographie zur Differentialdiagnose und Differentialtherapie des ischämischen Großhirninfarktes. Fortschr Neurol Psychiatr 53:315–334

    Google Scholar 

  57. Roberts MA, McGeorge AP, Caird FI (1978) Electroencephalography and computerised, tomography in vascular and non-vascular dementia in old age. J Neurol Neurosurg Psychiatry 41:903–906

    Google Scholar 

  58. Rocca WA, Hofman A, Brayne C, Breteler MMB, Clarke M, Copeland JRM, Dartigues JF, Engedal K, Hagnell O, Heeren TJ, Jonker C, Lindesay J, Lobo A, Mann AH, Mölsa PK, Morgan K, O'Connor DW, Silva Droux A da, Sulkava R, Kay DWK, Amaducci L for the EURODEM — Prevalence Research Group (1991) The prevalence of vascular dementia in Europe: facts and fragments from 1980–1990 studies. Ann Neurol 30:817–824

    Google Scholar 

  59. Rogers RL, Meyer JS, Mortel KF, Mahurin RK, Judd BW (1986) Decreased cerebral blood flow precedes multi-infarct dementia, but follows senile dementia of Alzheimer type. Neurology 36:1–6

    Google Scholar 

  60. Roman GC (1988) Why not Binswanger's disease? Arch Neurol 45:141–142

    Google Scholar 

  61. Rosen WG, Terry RD, Fuld PA, Katzman R, Peck A (1980) Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 7:486–488

    Google Scholar 

  62. Roth M, Tym E, Mountjoy CQ, Huppert PA, Hendrie H, Verma S, Goddard R (1986) CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 149:698–709

    Google Scholar 

  63. Salgado ED, Weinstein M, Furlan AJ, Modic MT, Beck GJ, Estes M, Awad I, Little JR (1986) Proton magnetic resonance imaging in ischemic cerebrovascular disease. Ann Neurol 20: 502–507

    Google Scholar 

  64. Scheinberg P (1988) Dementia due to vascular disease—a multifactorial disorder. Stroke 19:1291–1299

    Google Scholar 

  65. Steingart A, Hachinski VC, Lau C, Fox AJ, Diaz F, Cape R, Lee D, Inzitari D, Merskey H (1987) Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computes tomography scan (leuko-araiosis). Arch Neurol 44:32–35

    Google Scholar 

  66. Steingart A, Hachinski VC, Lau C, Fox AJ, Fox H, Lee D, Inzitari D, Merskey H (1987) Cognitive and neurologic findings in demented patients with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol 44: 36–39

    Google Scholar 

  67. Sulkava R, Erkinjuntti T (1987) Vascular dementia due to cardiac arrhythmias and systemic hypotension. Acta Neurol Scand 76:123–128

    Google Scholar 

  68. Szelies B, Herholz K, Pawlik G, Karbe H, Herbold I, Heiss WD (1991) Widespread functional effects of discrete thalamic infarction. Arch Neurol 48:178–182

    Google Scholar 

  69. Tanaka Y, Tanaka O, Mizuno Y, Yoshida M (1989) A radiologic study of dynamic processes in lacunar dementia. Stroke 20:1488–1493

    Google Scholar 

  70. Tatemichi TK, Foulkes MA, Mohr JP, Hewitt JR, Hier DB, Price TR, Wolf PA (1990) Dementia in stroke survivors in the stroke data bank cohort. Stroke 21:858–866

    Google Scholar 

  71. Tatemichi TK, Desmond DW, Mayeux R, Paik M, Stern Y, Sano M, Remien RH, Williams JBW, Mohr JP, Hauser WA, Figueroa M (1992) Dementia after stroke: baseline frequency, risks, and clinical features in a hospitalized cohort. Neurology 42:1185–1193

    Google Scholar 

  72. Tierney MC, Fisher RH, Lewis AJ, Zorzitto ML, Snow WG, Reid DW, Nieuwstraten P (1988) The NINCDS-ADRDA work group criteria for the clinical diagnosis of probably Alzheimer's disease: a clinico-pathologic study of 57 cases. Neurology 38:359–364

    Google Scholar 

  73. Todorov AB, Go RCP, Constantinidis J, Elston RC (1975) Specificity of the clinical diagnosis of dementia. J Neurol Sci 26:81–98

    Google Scholar 

  74. Tomlinson BE, Blessed G, Roth M (1970) Observations on the brains of demented old people?. J Neurol Sci 11:331–356

    Google Scholar 

  75. Tuszynski MH, Petito CK, Levy DE (1989) Risk factors and clinical manifestations of pathologically verified lacunar infarctions. Stroke 20:990–999

    Google Scholar 

  76. Ulrich J, Probst A, West M (1986) The brain diseases causing senile dementia. J Neurol 233:118–122

    Google Scholar 

  77. Wallin A, Blennow K, Uhlemann C, Langström G, Gottfries CG (1989) White matter low attenuation on computed tomography in Alzheimer's disease and vascular dementia — diagnostic and pathogenetic aspects. Acta Neurol Scand 80:518–523

    Google Scholar 

  78. Wallin A, Blennow K (1991) Pathogenetic basis of vascular dementia. Alzheimer Dis Assoc Disord 5:91–102

    Google Scholar 

  79. World Health Organization (1992) ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva, pp 50–51

    Google Scholar 

  80. Zaudig M, Mittelhammer J, Hiller W, Pauls A, Thora C, Morinigo A, Mombour W (1991) SIDAM — A structures interview for the diagnosis of dementia of the Alzheimer type, multiinfarct dementia and dementias of other etiology according to ICD-10 and DSM-III-R. Psychol Med 21:225–236

    Google Scholar 

  81. Zeumer H, Hacke W, Kolmann HL, Ringelstein EB (1982) Subcortical arteriosclerotic encephalopathy (Binswanger's disease). Exp Brain Res [Suppl 5]:272–276

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wetterling, T., Kanitz, R.D. & Borgis, K.J. Clinical evaluation of the ICD-10 criteria for vascular dementia. Eur Arch Psychiatry Clin Nuerosci 243, 33–40 (1993). https://doi.org/10.1007/BF02191521

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02191521

Key words

Navigation