Diagnostic evaluation of degenerative and vascular dementia.

The accuracy of the Ischemic Score (IS) of Hachinski in the differential diagnosis between senile dementia (SDAT) and multi-infarct dementia (MID) is evaluated in this study. Ninety-four demented patients were subdivided on the basis of CT scan in three subgroups: 1) CT-SDAT (ventricular enlargement and widening of cortical sulci), 2) CT-MID (multiple low density areas attributable to ischemic lesions), 3) CT-VASC (single low density area attributable to ischemic lesion). Sixty-nine percent of patients with SDAT and 94% of patients with MID had an Ischemic Score in agreement with the diagnosis established by CT scan. With the purpose of improving the accuracy of the I.S., a modified ischemic score consisting of five items (abrupt onset; history of strokes; focal symptoms; focal signs; focal (single or multiple) CT-low density areas) is proposed as a useful tool in the differential diagnosis between SDAT and MID.