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• W2895823016 abstract "Lewy body dementia (LBD), consisting of dementia with Lewy bodies (DLB) and Parkinson's disease (PD) dementia (PDD), makes up >15% of cases at autopsy, however clinical prevalence rates are much lower at 5-6%. Here we review the diagnostic pathways of LBD to explore possible reasons. We reviewed the medical notes of 74 DLB and 72 non-DLB dementia cases matched for age, gender and cognitive performance, together with 38 PDD cases and 35 PD cases, matched for age and gender, from two geographically distinct UK regions. DLB cases took longer to reach a final diagnosis, underwent more imaging tests, had more clinical assessments at home and had more alternative prior diagnoses, than their non-DLB counterparts (table 1). Age at referral negatively correlated with time to final diagnosis in DLB subjects (Pearson's; R=-0.44, p<0.001; see figure 1) but not non-DLB subjects (Pearson's; R= -0.21, p=0.08). Cases diagnosed in East Anglia compared to the North East had significantly more core features (as specified by the 2005 consensus criteria), but fewer suggestive features, with cases in the North East having significantly more dopamine transporter (DAT) scans performed (table 2). However there were no significant differences in the time to reach the final diagnoses between regions. For PDD, 46% (12/26 PDD cases) had impaired activities of daily living due to cognitive impairment, 57% (16/28) had cognitive impairment in multiple domains, and 38% (6/16) had both, prior to a diagnosis of dementia being recorded. 42% (10/24) of patients received treatment for dementia before a dementia diagnosis. Visual hallucinations and fluctuations were also significantly more common in the group diagnosed with dementia (table 3). Correlation between Time from First Appointment to Final Diagnosis and Age of DLB subjects. Our results suggest DLB patients, particularly those on the younger end of the old age spectrum, experience delays in their diagnosis and are often misdiagnosed initially. The variation in the use of DAT scans, and the number of core features in diagnosed subjects, suggest different thresholds for clinical diagnosis between regions. This, and results suggesting that diagnosis of dementia in PD is delayed beyond the onset of symptoms, may explain the low rates of LBD diagnosis seen clinically." @default.
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• W2895823016 date "2018-07-01" @default.
• W2895823016 modified "2023-10-18" @default.
• W2895823016 title "O5‐03‐05: DELAYS IN DIAGNOSING LEWY BODY DEMENTIA" @default.
• W2895823016 doi "https://doi.org/10.1016/j.jalz.2018.06.3011" @default.
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