Introduction: Dementia with Lewy bodies (DLB) may represent a diagnostic challenge, since its clinical picture overlaps with other dementia. Two toolkits have been developed to aid the clinician to diagnose DLB: the Lewy Body Composite Risk Score (LBCRS) and the Assessment Toolkit for DLB (AT-DLB). We aim to evaluate the reliability of these two questionnaires, and their ability to enhance the interpretation of the international consensus diagnostic criteria. Methods: LBCRS and AT-DLB were distributed to 135 Italian Neurological Centers for Cognitive Decline and Dementia (CDCDs), with the indication to administer them to all patients with dementia referred within the subsequent 3 months. We asked to subsequently apply consensus criteria for DLB diagnosis, to validate the diagnostic accuracy of the two toolkits. Results: A total of 23 Centers joined the study; 1854 patients were enrolled. We found a prevalence of possible or probable DLB of 13% each (26% total), according to the consensus criteria. LBCRS toolkit showed good reliability, with a Cronbach alpha of 0.77, stable even after removing variables from the construct. AT-DLB toolkit Cronbach alpha was 0.52 and, after the subtraction of the "cognitive fluctuation" criterion, was only 0.31. Accuracy, sensitivity, and specificity were higher for LBCRS vs. AT-DLB. However, when simultaneously considered in the logistic models, AT-DLB showed a better performance (p < 0.001). Overall, the concordance between LBCRS positive and AT-DLB possible/probable was of 78.02% CONCLUSIONS: In a clinical setting, the LBCRS and AT-DLB questionnaires have good accuracy for DLB diagnosis.

Accuracy of the clinical diagnosis of dementia with Lewy bodies (DLB) among the Italian Dementia Centers: a study by the Italian DLB study group (DLB-SINdem)

Mauri, Marco
Investigation
;
2022-01-01

Abstract

Introduction: Dementia with Lewy bodies (DLB) may represent a diagnostic challenge, since its clinical picture overlaps with other dementia. Two toolkits have been developed to aid the clinician to diagnose DLB: the Lewy Body Composite Risk Score (LBCRS) and the Assessment Toolkit for DLB (AT-DLB). We aim to evaluate the reliability of these two questionnaires, and their ability to enhance the interpretation of the international consensus diagnostic criteria. Methods: LBCRS and AT-DLB were distributed to 135 Italian Neurological Centers for Cognitive Decline and Dementia (CDCDs), with the indication to administer them to all patients with dementia referred within the subsequent 3 months. We asked to subsequently apply consensus criteria for DLB diagnosis, to validate the diagnostic accuracy of the two toolkits. Results: A total of 23 Centers joined the study; 1854 patients were enrolled. We found a prevalence of possible or probable DLB of 13% each (26% total), according to the consensus criteria. LBCRS toolkit showed good reliability, with a Cronbach alpha of 0.77, stable even after removing variables from the construct. AT-DLB toolkit Cronbach alpha was 0.52 and, after the subtraction of the "cognitive fluctuation" criterion, was only 0.31. Accuracy, sensitivity, and specificity were higher for LBCRS vs. AT-DLB. However, when simultaneously considered in the logistic models, AT-DLB showed a better performance (p < 0.001). Overall, the concordance between LBCRS positive and AT-DLB possible/probable was of 78.02% CONCLUSIONS: In a clinical setting, the LBCRS and AT-DLB questionnaires have good accuracy for DLB diagnosis.
Clinical diagnosis; Cognitive impairment; Consensus criteria; Dementia; Dementia with Lewy bodies; Diagnostic accuracy; Diagnostic toolkits
Russo, Mirella; Carrarini, Claudia; Di Iorio, Angelo; Pellegrino, Raffaello; Bruni, Amalia Cecilia; Caratozzolo, Salvatore; Chiari, Annalisa; Pretta, Stefano; Marra, Camillo; Cotelli, Maria Sofia; Arighi, Andrea; Fumagalli, Giorgio G; Cataruzza, Tatiana; Caso, Francesca; Paci, Cristina; Rosso, Mara; Amici, Serena; Giannandrea, David; Pilotto, Andrea; Luzzi, Simona; Castellano, Annalisa; D'Antonio, Fabrizia; Luca, Antonina; Gelosa, Giorgio; Piccoli, Tommaso; Mauri, Marco; Agosta, Federica; Babiloni, Claudio; Borroni, Barbara; Bozzali, Marco; Filippi, Massimo; Galimberti, Daniela; Monastero, Roberto; Muscio, Cristina; Parnetti, Lucilla; Perani, Daniela; Serra, Laura; Silani, Vincenzo; Tiraboschi, Pietro; Cagnin, Annachiara; Padovani, Alessandro; Bonanni, Laura
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2130004
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