Unifying Concepts

Hachinski Ischemic Scale (HIS)

The Hachinski ischemic score (HIS) is known to be a simple clinical tool, currently used for differentiating major types of dementia, such as primary degenerative, vascular or multi-infarct, and mixed type.

Hachinski Ischemic Scale

Feature Value
Abrupt onset 2
Stepwise deterioration 1
Fluctuating course 2
Nocturnal confusion 1
Relative preservation of personality 1
Depression 1
Somatic complaints 1
Emotional incontinence 1
History or presence of hypertension 1
History of strokes 2
Evidence of atherosclerosis 1
Focal neurological symptoms 2
Focal neurological signs 2

Patients scoring 7 or greater are classified as having “multi-infarct dementia”, and patients scoring </= 4 are classified as having “primary degenerative dementia”. A score of 5 or 6 is considered as an intermediate value and is usually designated as “mixed dementia”.



  1. Hachinski V, Oveisgharan S, Romney AK, Shankle WR. Optimizing the Hachinski Ischemic Scale. Arch Neurol. 2012 Feb;69(2):169-75. [Medline]
  2. Saposnik G, Raptis S, Kapral MK, Liu Y, Tu JV, Mamdani M, Austin PC; Investigators of the Registry of the Canadian Stroke Network and the Stroke Outcome Research Canada Working Group. The iScore predicts poor functional outcomes early after hospitalization for an acute ischemic stroke. Stroke. 2011 Dec;42(12):3421-8. [Medline]
  3. Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, Russell RW, Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632-7. [Medline]


Created Sep 08, 2015.

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