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Preclinical syndromes predict dementia: the Sydney older persons study
L M Waite1, G A Broe, D A Grayson
1Centre for Education and Research on Ageing, Concord Hospital C25, University of Sydney, NSW 2139, Australia. lwaite@medicine.usyd.edu.au
Journal of Neurology, Neurosurgery, and Psychiatry
|August 21, 2001
Summary
Preclinical syndromes for dementia are common and predict future dementia development. However, their positive predictive value is low, requiring further research for clinical application.
Area of Science:
- Neurology
- Gerontology
- Epidemiology
Background:
- Early identification of dementia is crucial for effective treatment.
- Preclinical syndromes may indicate future dementia risk.
Purpose of the Study:
- To determine if preclinical syndromes for Alzheimer's disease, vascular dementia, and Parkinson's disease exist.
- To assess the predictive value of these syndromes for dementia incidence and mortality.
Main Methods:
- A longitudinal study of 647 community-dwelling individuals aged 75+.
- Assessment included medical history, neuropsychological testing, and physical examination.
- Preclinical syndromes defined by cognitive, motor, and vascular features.
Main Results:
- Preclinical syndromes were present in 55.7% of subjects.
- These syndromes significantly increased the odds of developing dementia (OR 4.81, p<0.001).
- Preclinical syndromes detected 89.7% of incident dementias, but had a positive predictive value of 19.4%.
Conclusions:
- Preclinical syndromes are sensitive predictors of dementia.
- Current definitions require refinement and longer observation periods for clinical use.
- Multiple coexisting preclinical disorders increase dementia incidence.
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