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Title: Prediction of poor clinical outcome in vascular cognitive impairment: TRACE-VCI study
Authors: Boomsma, JMF
Exalto, LG
Barkhof, F
Chen, CLH 
Hilal, S 
Leeuwis, AE
Prins, ND
Saridin, FN 
Scheltens, P
Teunissen, CE
Verwer, JH
Weinstein, HC
van der Flier, WM
Biessels, GJ
Benedictus, MR
Bremer, J
Leijenaar, J
van Maurik, IS
Tijms, BM
Wattjes, MP
Koene, T
van den Berg, E
Ferro, DA
Frijns, CJM
Groeneveld, ON
Heinen, R
van Kalsbeek, NM
de Bresser, J
Kuijf, HJ
Koek, HL
Pleizier, CM
Vriens, EM
Hamaker, ME
Faaij, RA
Venketasubramanian, N 
Villaraza, S
Xu, X
Tan, BY
Keywords: cognitive decline
major vascular event
memory clinic
poor clinical outcome
prediction score
vascular cognitive impairment
Issue Date: 1-Jan-2020
Publisher: Wiley
Citation: Boomsma, JMF, Exalto, LG, Barkhof, F, Chen, CLH, Hilal, S, Leeuwis, AE, Prins, ND, Saridin, FN, Scheltens, P, Teunissen, CE, Verwer, JH, Weinstein, HC, van der Flier, WM, Biessels, GJ, Benedictus, MR, Bremer, J, Leijenaar, J, van Maurik, IS, Tijms, BM, Wattjes, MP, Koene, T, van den Berg, E, Ferro, DA, Frijns, CJM, Groeneveld, ON, Heinen, R, van Kalsbeek, NM, de Bresser, J, Kuijf, HJ, Koek, HL, Pleizier, CM, Vriens, EM, Hamaker, ME, Faaij, RA, Venketasubramanian, N, Villaraza, S, Xu, X, Tan, BY (2020-01-01). Prediction of poor clinical outcome in vascular cognitive impairment: TRACE-VCI study. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring 12 (1) : e12077-. ScholarBank@NUS Repository.
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.
Source Title: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
ISSN: 2352-8729
DOI: 10.1002/dad2.12077
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