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Prediction of poor clinical outcome in vascular cognitive impairment: TRACE-VCI study

Boomsma, JMF; Exalto, LG; Barkhof, F; Chen, CLH; Hilal, S; Leeuwis, AE; Prins, ND; ... TRACE‐VCI study group, .; + view all (2020) Prediction of poor clinical outcome in vascular cognitive impairment: TRACE-VCI study. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring , 12 (1) , Article e12077. 10.1002/dad2.12077. Green open access

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Abstract

INTRODUCTION: Prognostication in memory clinic patients with vascular brain injury (eg possible vascular cognitive impairment [VCI]) is often uncertain. We created a risk score to predict poor clinical outcome. METHODS: Using data from two longitudinal cohorts of memory clinic patients with vascular brain injury without advanced dementia, we created (n = 707) and validated (n = 235) the risk score. Poor clinical outcome was defined as substantial cognitive decline (change of Clinical Dementia Rating ≥1 or institutionalization) or major vascular events or death. Twenty‐four candidate predictors were evaluated using Cox proportional hazard models. RESULTS: Age, clinical syndrome diagnosis, Disability Assessment for Dementia, Neuropsychiatric Inventory, and medial temporal lobe atrophy most strongly predicted poor outcome and constituted the risk score (C‐statistic 0.71; validation cohort 0.78). Of note, none of the vascular predictors were retained in this model. The 2‐year risk of poor outcome was 6.5% for the lowest (0‐5) and 55.4% for the highest sum scores (10‐13). DISCUSSION: This is the first, validated, prediction score for 2‐year clinical outcome of patients with possible VCI.

Type: Article
Title: Prediction of poor clinical outcome in vascular cognitive impairment: TRACE-VCI study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/dad2.12077
Publisher version: https://doi.org/10.1002/dad2.12077
Language: English
Additional information: © 2020 the Alzheimer's Association. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/).
Keywords: cognitive decline, death, major vascular event, memory clinic, poor clinical outcome, prediction score, prognosis, vascular cognitive impairment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
URI: https://discovery.ucl.ac.uk/id/eprint/10108408
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