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Clinical variables related to the diagnostic stability of demential syndromes

Published online by Cambridge University Press:  15 June 2017

Fabiano Moulin de Moraes Open the ORCID record for Fabiano Moulin de Moraes [Opens in a new window]  and
Paulo Henrique Ferreira Bertolucci
Fabiano Moulin de Moraes*
Affiliation:
Service of Cognitive and Behavioral Neurology, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo,SP, Brazil
Paulo Henrique Ferreira Bertolucci
Affiliation:
Service of Cognitive and Behavioral Neurology, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo,SP, Brazil
*
Correspondence should be addressed to: Fabiano Moulin de Moraes, Service of Cognitive and Behavioral Neurology of the Department of Neurology and Neurosurgery of the Federal University of São Paulo, Rua Pedro de Toledo, 650, Vila Clementino, CEP 04039002, São Paulo, SP, Brazil. Phone: 55(11)55764848. Email: [email protected].
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Abstract

Background:

Assigning a diagnosis to a patient with dementia is important for the present treatment of the patient and caregivers, and scientific research. Nowadays, the dementia diagnostic criteria are based on clinical information regarding medical, history, physical examination, neuropsychological tests, and supplementary exams and, therefore, subject to variability through time.

Methods:

A retrospective observational study to evaluate variables related to clinical diagnostic stability in dementia syndromes in at least one year follow up. From a sample of 432 patients, from a single university center, data were collected regarding sociodemographic aspects, Clinical Dementia Rating, physical examination, neuropsychological tests, and supplementary exams including a depression triage scale.

Results:

From this sample, 113 (26.6%) patients have their diagnosis changed, most of them adding a vascular component to initial diagnosis or depression as comorbidity or main disease. Our findings show that many factors influence the diagnostic stability including the presence of symmetric Parkinsonism, initial diagnosis of vascular dementia, presence of diabetes and hypertension, the presence of long term memory deficit in the neuropsychological evaluation, and normal neuroimaging. We discuss our findings with previous findings in the literature.

Conclusion:

Every step of the clinical diagnosis including history, vascular comorbidities and depression, physical examination, neuropsychological battery, and neuroimaging were relevant to diagnosis accuracy.

Keywords

Dementiadiagnosisancillary examsalzheimerdepressionneuroimage
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 10 , October 2017 , pp. 1735 - 1741
Copyright
Copyright © International Psychogeriatric Association 2017 

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