Is VaD distinguishable from AD?

• Patients who meet clinical criteria for VaD may also have AD pathology but

  • specificity of NINDS-AIREN criteria are high (91%) for exclusion of AD (Gold et al., Neurology 1997;49:690-694)
  • other evidence suggests that dementia in patients with VaD (even due to subcortical ischemic vascular disease) does not simply indicate the presence of AD (Fein et al., Neurology 2000;55:1626-1635)
  • requirement for statistical and clinically relevant effect in VaD treatment study will preclude possibility that effect is entirely due to treatment of AD

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