Journal Mobile Options
Table of Contents
Vol. 10, No. 2, 1999
Issue release date: March–April 1999
Dement Geriatr Cogn Disord 1999;10:104–108
(DOI:10.1159/000017109)

Simple Standardised NeuropsychologicalAssessments Aid in the Differential Diagnosis of Dementia with Lewy Bodies from Alzheimer’s Disease and Vascular Dementia

Ballard C.G. · Ayre G. · O’Brien J. · Sahgal A. · McKeith I.G. · Ince P.G. · Perry R.H.
aMRC Neurochemical Pathology Unit, and bUniversity of Newcastle upon Tyne, Newcastle upon Tyne, UK

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Consecutive patients from a dementia case register received a standardised evaluation which incorporated a neuropsychological assessment with the Cambridge Assessment for disorders in the elderly (CAMCOG). Operationalised clinical diagnoses were made (consensus criteria for dementia with Lewy bodies, DLB; NINCDS- ADRDA for Alzheimer’s disease, AD, NINCDS AIRENS for vascular dementia, VaD). Two-hundred and twenty-eight patients were studied (DLB 54, AD102, VaD 72). DLB patients had significantly better performance on recent memory than AD patients, but more impaired visuospatial praxis. DLB patients also had significantly better recent memory than those with VaD. Optimal cut-off points for the recent memory:praxis ratio achieved good discrimination between DLB and both other dementias.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Cummings JL, Benson DF: Dementia: Definition, Prevalence, Classification and Approach to Diagnosis; in Cummings JL, Benson DF (eds): Dementia: A Clinical Approach. Boston, Butterworth-Heineman, 1992.
  2. Rocca WA, Hofman A, Brayne C, Breteler MMB, Clarke M, Copeland JRM: The Prevalence of Vascular Dementia in Europe: Facts and Fragments from 1980–1990 studies. EURODERM – Prevalence Research Group. Ann Neurol 1991;30:817–824.
  3. Lennox G, Lowe J, Morrell K, Landon M, Mayer RJA: Antiubiquitin immunocytochemistry is more sensitive than conventional techniques in the detection of diffuse Lewy body disease. J Neurol Neurosurg Psychiatry 1989;52:67–71.
  4. Burns A, Luthert P, Levy R, Jacoby R, Lantos P: Accuracy of clinical diagnosis of Alzheimer’s disease. Br Med J 1990;301:1026.
  5. Hansen L, Salmon D, Galasko D, Maslisah E, Katzman R, de Terese R, Thal L, Pay MM, Hojstatter R, Klauber M: The Lewy body variant of Alzheimer’s disease: A clinical and pathological entity. Neurology 1990;40:1–8.
  6. Perry RH, Irving D, Blessed G, Fairbairn A, Perry EK: A clinically and pathologically distinct form of Lewy body dementia in the elderly. J Neurol Sci 1990;95:119–139.
  7. Dickson DW, Ruan D, Crystal H, Mark MH, Davies P, Kres Y, Yen SH: Hippocampal degeneration differentiates diffuse Lewy body disease (DLBD) from Alzheimer’s disease: Light and electron microscopic immunocytochemistry of CA2-3 neurites specific to DLBD. Neurology 1991;41:1402–1409.
  8. Kosaka K: Diffuse Lewy body disease in Japan. J Neurol 1990;237:197–204.
  9. Perry RH, Irving D, Blessed E, Perry EK, Fairbairn AF: Clinically and neuropathologically distinct form of dementia in the elderly. Lancet 1989;1:166.
  10. McKeith IG, Fairbairn A, Perry R, Thompson P, Perry E: Neuroleptic sensitivity in patients with senile dementia of Lewy body type. BMJ 1992;305:673–678.
  11. McKeith IG, Ballard CG, Harrison RWS: Neuroleptic sensitivity to risperidone in Lewy body dementia. Lancet 1995;346:699.

    External Resources

  12. Ballard C, Grace J, McKeith I, Holmes C: Neuroleptic sensitivity in dementia with Lewy bodies and Alzheimer’s disease. Lancet 1998;35:1032–1033.
  13. Levy R, Eagger S, Griffiths M: Lewy bodies and response to tacrine in Alzheimer’s disease. Lancet 1994;343:176.
  14. McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, Salmon DP, Lowe J, Mirra SS, Byrne EJ, Lennox G, Quinn NP, Edwardson JA, Ince PG, Bergeron C, Burns A, Miller BL, Lovestone S, Collerton D, Jansen ENH, Ballard C, de Vos RAI, Wilcock GK, Jellinger KA, Perry RH: Consensus Guidelines for the Clinical and Pathological Diagnosis of Dementia with Lewy Bodies (DLB): Report of the Consortium on DLB International Workshop. Neurology 1996;47:1113–1124.
  15. Galloway PH, Sahgal A, McKeith IG: Visual pattern recognition memory and learning deficits in senile dementias of Alzheimer and Lewy body types. Dementia 1992;3:101–107.
  16. Salmon DP, Galasko D: Neuropsychological Aspects of Lewy Body Dementia; in Perry R, McKeith I, Perry E (eds): Dementia with Lewy Bodies. Clinical, Pathological and Treatment Issues. Cambridge, Cambridge University, 1996, pp 99–113.
  17. Sahgal A, Galloway PH, McKeith IG: Matching-to-sample deficits in patients with senile dementias of the Alzheimer and Lewy body types. Arch Neurol 1992;49:1043–1046.
  18. Sahgal A, Galloway PH, McKeith IG, Edwardson JA, Lloyd S: A comparative study of attentional deficits in senile dementias of Alzheimer and Lewy body types. Dementia 1992;3:350–354.
  19. Sahgal A, McKeith IG, Galloway PH, Tasker N, Steckler T: Do differences in visuospatial ability between senile dementias of the Alzheimer and Lewy body types reflect differences solely in mnemonic function? J Clin Exp Neuropsychol 1995;17:35–43.
  20. Gnanalingham KK, Byrne EJ, Thornton A, Sambrook MA, Bannister P: Motor and cognitive function in Lewy body dementia: Comparison with Alzheimer and Parkinson’s disease. J Neurol Neurosurg Psychiatry 1997;62:243–252.
  21. Walker Z, Allen RL, Shergill S: Neuropsychological performance in Lewy body dementia and Alzheimer’s disease. Br J Psychiatry 1997;170:156–158.
  22. Folstein MF, Folstein SE, McHugh PR: Mini-Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 1975;12:189–198.
  23. Dewey ME, Copeland JRM, Lobo A, Saz P, Dia SL: Computerised diagnosis from a Standardised History Schedule: A preliminary communication about the organic section of the HAS-AGECAT system. Int J Ger Psychiatry 1992;7:443–446.
  24. Roth M, Tym E, Mountjoy C, Huppert F, Hendrie J, Verma S, Goddard R: CAMDEX: A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698–709.
  25. Fahn S, Elton R, and Unified Parkinson’s Disease Rating Scale Committee: Unified Parkinson’s Disease Rating Scale; in Fahn S, Marsden CD, Calne D (eds): Recent Developments in Parkinson’s Disease. New York, Macmillan, 1987.
  26. Ballard C, McKeith I, Burn D, Harrison R, O’Brien J, Lowery K, Campbell M, Perry R, Ince P: The UPDRS scale as a means of identifying extrapyramidal signs in patients suffering from dementia with Lewy bodies. Acta Neurol Scand 1997;96:366–371.
  27. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlen EM: Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the Auspices of Department of Health and Human Services Task Forces on Alzheimer’s Disease. Neurology 1984;34:939–944.
  28. Roman GC, Tatemichi T, Erkinjuntti T, Cummings JL, Masden JC, Garcia JH: Vascular Dementia: Diagnostic Criteria for Research Studies. Report of the NINCDS AIRENS. International Workshop. Neurology 1993;43:250–260.
  29. Mirra SS, Heyman A, McKeel D, Sumi SM, Crain BJ, Brownlee LM, Vogel FS, Hughes JP, van Belle G, Berg L and Participating CERAD Neuropathologists: The Consortium to establish a registry for Alzheimer’s disease (CERAD). II. Standardisation of the neuropathological assessment of Alzheimer’s disease. Neurology 1991;41:479–486.
  30. SPSS (1992) Statistical Package for the Social Sciences. Windows Version, release 5,0. Chicago, SPSS Inc.
  31. McKeith IG, Ballard CG, Perry RH, Ince PG, Jaros E, Neill D, O’Brien J: Predictive accuracy of clinical diagnostic criteria for dementia with Lewy bodies – A prospective neuropathological validation study (abstract). Neurology 1998;50:Suppl 4, 181.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50