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) / Russo, M.; Carrarini, C.; Di Iorio, A.; Pellegrino, R.; Bruni, A. C.; Caratozzolo, S.; Chiari, A.; Pretta, S.; Marra, C.; Cotelli, M. S.; Arighi, A.; Fumagalli, G. G.; Cataruzza, T.; Caso, F.; Paci, C.; Rosso, M.; Amici, S.; Giannandrea, D.; Pilotto, A.; Luzzi, S.; Castellano, A.; D'Antonio, F.; Luca, A.; Gelosa, G.; Piccoli, T.; Mauri, M.; Agosta, F.; Babiloni, C.; Borroni, B.; Bozzali, M.; Filippi, M.; Galimberti, D.; Monastero, R.; Muscio, C.; Parnetti, L.; Perani, D.; Serra, L.; Silani, V.; Tiraboschi, P.; Cagnin, A.; Padovani, A.; Bonanni, L.; Roberta, B.; Federica, F.; Sebastiano, G.; Caterina, G.; Gianmarco, G.; Giuseppe, M.; Giulia, M.; Stefano, M.; Carmela, R.; Marco, R.; Pierpaolo, S.; Giuseppe, S. P.; Marinella, T.; Federico, V.; Antonietta, V. M.. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 43:7(2022), pp. 4221-4229. [10.1007/s10072-022-05987-z]

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)

Fumagalli G. G.;
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.
2022
7
Russo, M.; Carrarini, C.; Di Iorio, A.; Pellegrino, R.; Bruni, A. C.; Caratozzolo, S.; Chiari, A.; Pretta, S.; Marra, C.; Cotelli, M. S.; Arighi, A.; Fumagalli, G. G.; Cataruzza, T.; Caso, F.; Paci, C.; Rosso, M.; Amici, S.; Giannandrea, D.; Pilotto, A.; Luzzi, S.; Castellano, A.; D'Antonio, F.; Luca, A.; Gelosa, G.; Piccoli, T.; Mauri, M.; Agosta, F.; Babiloni, C.; Borroni, B.; Bozzali, M.; Filippi, M.; Galimberti, D.; Monastero, R.; Muscio, C.; Parnetti, L.; Perani, D.; Serra, L.; Silani, V.; Tiraboschi, P.; Cagnin, A.; Padovani, A.; Bonanni, L.; Roberta, B.; Federica, F.; Sebastiano, G.; Caterina, G.; Gianmarco, G.; Giuseppe, M.; Giulia, M.; Stefano, M.; Carmela, R.; Marco, R.; Pierpaolo, S.; Giuseppe, S. P.; Marinella, T.; Federico, V.; Antonietta, V. M.
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) / Russo, M.; Carrarini, C.; Di Iorio, A.; Pellegrino, R.; Bruni, A. C.; Caratozzolo, S.; Chiari, A.; Pretta, S.; Marra, C.; Cotelli, M. S.; Arighi, A.; Fumagalli, G. G.; Cataruzza, T.; Caso, F.; Paci, C.; Rosso, M.; Amici, S.; Giannandrea, D.; Pilotto, A.; Luzzi, S.; Castellano, A.; D'Antonio, F.; Luca, A.; Gelosa, G.; Piccoli, T.; Mauri, M.; Agosta, F.; Babiloni, C.; Borroni, B.; Bozzali, M.; Filippi, M.; Galimberti, D.; Monastero, R.; Muscio, C.; Parnetti, L.; Perani, D.; Serra, L.; Silani, V.; Tiraboschi, P.; Cagnin, A.; Padovani, A.; Bonanni, L.; Roberta, B.; Federica, F.; Sebastiano, G.; Caterina, G.; Gianmarco, G.; Giuseppe, M.; Giulia, M.; Stefano, M.; Carmela, R.; Marco, R.; Pierpaolo, S.; Giuseppe, S. P.; Marinella, T.; Federico, V.; Antonietta, V. M.. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 43:7(2022), pp. 4221-4229. [10.1007/s10072-022-05987-z]
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