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

Jooske M.F. Boomsma, L. G. Exalto, the TRACE-VCI study group, Frederik Barkhof, Christopher L.H. Chen, S. Hilal, Anna E. Leeuwis, Niels D. Prins, F. N. Saridin, Philip Scheltens, Charlotte E. Teunissen, Jurre H. Verwer, Henry C. Weinstein, W. M. van der Flier, G. J. Biessels*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
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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.

Original languageEnglish
Article numbere12077
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume12
Issue number1
DOIs
Publication statusPublished - 2020

Bibliographical note

Funding Information:
The TRACE‐VCI study was supported by Vidi grant 917.11.384 and Vici grand 918.16.616 from ZonMw, the Netherlands, Organisation for Health Research and Development and grant 2010T073 from the Dutch Heart Association to Geert Jan Biessels.
Research of the Alzheimer center, Vrije Universiteit Amsterdam,
Amsterdam UMC is part of the neurodegeneration research program of the Amsterdam Neuroscience. The Alzheimer Center, Vrije
Universiteit Amsterdam, Amsterdam UMC, is supported by Stichting Alzheimer Nederland and Stichting Vrije Universiteit Amsterdam,
Amsterdam UMC fonds. The clinical database structure was developed
with funding from Stichting Dioraphte.
Frederik Barkhof is supported by the National Institute for Health
Research (NIHR) and University College London Hospitals NHS Foundation Trust (UCLH) biomedical research center, London, United
Kingdom.



Publisher Copyright:
© 2020 the Alzheimer's Association

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