Discriminating power of the hachinski ischaemic score in a geriatric population with mild dementia

✍ Scribed by Dr. Gregory R. J. Swanwick; Robert F. Coen; Brian A. Lawlor; Denis O'Mahony; J. Bernard Walsh; Davis Coakley

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 573 KB
• Volume: 10
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.930100808

✦ Synopsis

Abstract

The Hachinski Ischaemic Score (HIS) is used to clinically discriminate multi‐infarct dementia (MID) and primary degenerative dementia (PDD). The present study aims to evaluate the discriminating power of the individual HIS items in a geriatric population with mild dementia. The 13 HIS items were studied in 93 demented subjects with no evidence of infarction, a single cortical infarct or multiple cortical infarcts on CT brain scan. The item ‘hypertension’ was a poor discriminator between PDD and MID in this elderly population; however, the remaining unambiguous items ‘abrupt onset’, ‘neurological sings’, ‘neurological symptoms’, ‘history of stroke’ and ‘atherosclerosis’ were useful discriminators. We found that five of the least discriminating items diverged from the aspects of MID that they were originally intended to address and were, therefore, particularly ambiguous. In order to improve the discriminating power of these items and the HIS as a whole, we recommend dividing the 13 items into four categories, ‘evidence of delirium’, ‘evidence of focal deficits’, ‘evidence of vascular pathology’ and ‘abrupt onset’, to minimize any problems with interpretation of the more ambiguous items.