Abstract
The Hachinski ischemic score (HIS) scale is a simple clinical tool proposed and currently used for differentiating types of dementia (primary degenerative, vascular or multi-infarct, mixed type). Criteria for rating the items of the HIS were never given, or inter-observer reliability in applying it has never been tested. However, the studies which estimated the validity of this scale in predicting the true diagnosis (clinical/CT or neuropathological definition) demonstrated acceptable sensitivity and specificity in defining degenerative or vascular dementia. This scale seems unable to define mixed type dementia or subtypes of vascular dementia. Our review supports the use of the HIS in epidemiological studies on dementia.
Sommario
La scala di Hachinski è un semplice strumento clinico proposto ed usato per differenziare diversi tipi di demenza (degenerativa primaria, vascolare o multiinfartuale, mista). I criteri per applicare gli items della scala di Hachinski non sono mai stati forniti e l'accordo tra osservatori non è mai stato testato. Tuttavia gli studi che hanno esaminato la validità di questa scala nel definire la demenza degenerativa e quella vascolare (confrontandole con il quadro clinico o con la TC o con l'esame neuropatologico) hanno dimostrato complessivamente una accettabile sensibilità e specificità. La scala di Hachinski non sembra poter definire la demenza mista o i sottotipi di demenza vascolare. La nostra review suggerisce di limitare l'uso della HIS agli studi epidemiologici sulla demenza, qualora indagini sofisticate e costose non possano essere utilizzate.
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Pantoni, L., Inzitari, D. Hachinski's ischemic score and the diagnosis of vascular dementia: A review. Ital J Neuro Sci 14, 539–546 (1993). https://doi.org/10.1007/BF02339212
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DOI: https://doi.org/10.1007/BF02339212