Early disease-specific characteristics for identifying Mixed Vascular-Alzheimer's Dementia in geriatric patients

Abstract

Abstract Purpose Mixed Vascular-Alzheimer's Dementia (MVAD) is coexistence of both Alzheimer's disease and cerebrovascular disease (CVD) in the same patient. Thus, the current investigation focused on retrospectively classifying and diagnosing older geriatric patients at risk for dementia with both vascular risk factors and neuro-atrophy factors in Alzheimer's disease (AD)versus patients with nonvascular-AD etiology. Methods The study evaluated demographic and clinical data collected from a cohort of 192 geriatric out-patients (age range = 60–97 years) admitted for one baseline and one follow-up clinical consultations within a period of three years. Mini Mental State Examination (MMSE) scores and cardiovascular risk factors were reevaluated and utilized in the assessment of basic cognitive functioning and clinical diagnosis of MVAD and AD dementia subgroups during follow-up visits. Results A relatively high prevalence of MVAD diagnosis was found across the entire sample (36%). MVAD diagnosis was significantly higher in men with 59% prevalence, while AD diagnosis without vascular etiology was significantly higher in women with 69% prevalence. MVAD diagnosis was more pronounced under the age of 85, while AD diagnosis without vascular history was significantly higher in ages 85 years or older. Importantly, non-palpations of peripheral pulse and atrial fibrillation-type arrhythmia were found to be significant early risk factors related to prospective MVAD diagnosis (p < .008, OR = 30, p < .009, OR = .005). Conclusion Early comprehensive clinical evaluation of specific vascular risk factors prior to dementia onset could putatively predict the onset of MVAD.