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

Jooske M F Boomsma, Lieza G Exalto, Frederik Barkhof, Christopher L H Chen, Saima Hilal, Anna E Leeuwis, Niels D Prins, Francis N Saridin, Philip Scheltens, Charlotte E Teunissen, Jurre H Verwer, Henry C Weinstein, Wiesje M van der Flier, Geert Jan Biessels, TRACE‐VCI study group

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)e12077
JournalAlzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Volume12
Issue number1
DOIs
Publication statusPublished - 2020

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