Recognition memory and verbal fluency differentiate probable Alzheimer disease from subcortical ischemic vascular dementia

Background: Alzheimer disease (AD) and vascular dementia are among the most frequently occurring causes of dementia in the world, and their accurate d ifferentiation is important because different pharmaceutical strategies may modify the course of each disease. \ Objective: To determine which of 10 n europsychological test scores can accurately differentiate patients with pr obable AD from those with subcortical ischemic vascular dementia (SIVD) for use in evidence-based clinical practice. Design: Patients with suspected dementia were referred to the study by fami ly physicians, geriatricians, and neurologists. All participants received a thorough assessment according to standard diagnostic guidelines. Diagnoses of probable AD (n=31) and probable SIVD (n=31) were made according to cons ensus criteria. The diagnosticians were blind to the results of the 10 neur opsychological test scores. Results: There were no significant differences between the groups in age or Mini-Mental State Examination scores. Logistic regression analyses identif ied 2 neuropsychological tests that best distinguished the groups (sensitiv ity=81%; specificity= 84%; positive likelihood ratio= 5.1). These were the recognition memory subtest of the Rey Auditory Verbal Learning Test and the Controlled Oral Word Association Test. The AD group performed better on th e oral association test, whereas the SIVD group did better on the recogniti on memory test. Conclusion: Patients with probable AD and probable SIVD can be distinguishe d with a high degree of accuracy using these 2 neuropsychological tests.