Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer’s disease

Ballard, C. and O'Brien, J. and Tovee, Martin (2002) Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer’s disease. Journal of Neurology Neurosurgery and Psychiatry, 72 (5). pp. 565-566. ISSN 0022-3050

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Abstract

Accurate and early clinical diagnosis of dementia with Lewy bodies (DLB) is essential for optimal management so that pitfalls such as severe neuroleptic sensitivity can be avoided, a trial of cholinesterase treatment can be instigated, and parkinsonian symptoms can be appropriately treated, weighing up the balance of psychiatric and motor symptoms and fall risk. In practice it has often been difficult to differentiate DLB from other forms of dementia, particularly Alzheimer’s disease. Several previous studies have suggested that DLB and Alzheimer’s disease can be differentiated on the basis of
visual and visuospatial tasks. The tasks most easily applicable to initial diagnosis are drawing tests (such as the clock
drawing). However, this approach ignores what is one of the more striking features of DLB: fluctuating cognition. Operationalised criteria for the clinical diagnosis of DLB (which do consider a broad range of symptoms) have achieved
high levels of specificity (> 90%); in many studies sensitivity has been as low as 50%. Probably the major obstacle to
accurate diagnosis has been the difficulty of identifying fluctuating cognition; for example, two inter-rater reliability studies have indicated that agreement.

Keywords:Alzheimer disease, attention, cognition, diffuse Lewy body disease, electroencephalogram, qualitative diagnosis, reaction time, Cognition Disorders, Lewy Body Disease, Neuropsychological Tests, Sensitivity and Specificity
Subjects:C Biological Sciences > C800 Psychology
C Biological Sciences > C850 Cognitive Psychology
C Biological Sciences > C830 Experimental Psychology
C Biological Sciences > C841 Health Psychology
C Biological Sciences > C840 Clinical Psychology
Divisions:College of Social Science > School of Psychology
ID Code:24520
Deposited On:11 Aug 2017 11:46

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