Accuracy of clinical diagnosis of dementia with lewy bodies versus neuropathology

Ragnhild Skogseth, T. Hortobágyi, Hogne Soennesyn, Luiza Chwiszczuk, Dominic Ffytche, Arvid Rongve, Clive Ballard, Dag Aarsland

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: The first consensus criteria for dementia with Lewy bodies (DLB) published in 1996 were revised in 2005, partly because the original clinical criteria had suboptimal sensitivity. Few studies have assessed the accuracy of the 2005 criteria applied prospectively in newly diagnosed patients who have been followed longitudinally. Objective: To explore the correlation between clinical and pathological diagnoses in patients with DLB and Parkinson's disease with dementia (PDD). Methods: From a prospective referral cohort study with enriched recruitment of patients with DLB and PDD, we included the first 56 patients coming to autopsy. Patients had mild dementia at inclusion and were followed annually until death with standardized clinical assessments. Pathological assessment was performed blind to clinical information according to standardized protocols and consensus criteria for DLB. Results: 20 patients received a pathological diagnosis of Lewy body disease; the corresponding clinical diagnoses were probable DLB (n = 11), PDD (n = 5), probable (n = 2) or possible (n = 2) Alzheimer's disease (AD). Of 14 patients with a clinical diagnosis of probable DLB, 11 had DLB/PDD and 3 had AD at pathology. One patient with clinically possible DLB fulfilled criteria for pathological AD. Sensitivity, specificity, positive predictive value, and negative predictive values for probable DLB were 73%, 93%, 79%, and 90%. Conclusion: Our findings suggest that the international clinical consensus criteria forDLBperform reasonably well. However, false positive and false negative diagnoses still occur, indicating that the criteria need to be improved, that biomarkers may be needed, and that neuropathological feedback is vital to improve accuracy.

Original languageEnglish
Pages (from-to)1139-1152
Number of pages14
JournalJournal of Alzheimer's Disease
Volume59
Issue number4
DOIs
Publication statusPublished - Jan 1 2017

Keywords

  • Autopsy
  • dementia
  • diagnosis
  • Lewy body disease
  • neuropathology
  • Parkinson's disease

ASJC Scopus subject areas

  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Accuracy of clinical diagnosis of dementia with lewy bodies versus neuropathology'. Together they form a unique fingerprint.

  • Cite this

    Skogseth, R., Hortobágyi, T., Soennesyn, H., Chwiszczuk, L., Ffytche, D., Rongve, A., Ballard, C., & Aarsland, D. (2017). Accuracy of clinical diagnosis of dementia with lewy bodies versus neuropathology. Journal of Alzheimer's Disease, 59(4), 1139-1152. https://doi.org/10.3233/JAD-170274