Fluctuating cognition in dementia with Lewy bodies and Alzheimer's disease is qualitatively distinct

Bradshaw J; Saling M; Hopwood M; Anderson V; Brodtmann A; Bradshaw, J; Saling, M; Hopwood, M; Anderson, V; Brodtmann, A
March 2004
Journal of Neurology, Neurosurgery & Psychiatry;Mar2004, Vol. 75 Issue 3, p382
Academic Journal
journal article
Objectives: To document and illustrate qualitative features of fluctuating cognition as described by care givers of patients with probable dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). To determine whether the quality of the fluctuations differs between DLB and AD. To examine the clinical utility of two recently developed rating scales.Methods: Care givers of 13 patients with early probable DLB and 12 patients with early probable AD were interviewed using the Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale, both developed recently. Descriptions of fluctuating cognition were recorded verbatim, analysed, and rated.Results: Descriptions of fluctuating cognition in DLB had a spontaneous, periodic, transient quality, which appeared to reflect an interruption in the ongoing flow of awareness or attention that impacted on functional abilities. Descriptions of fluctuations in AD frequently highlighted episodes of memory failure, or a more enduring state shift in the form of "good" and "bad" days, typically occurring in response to the cognitive demands of the immediate environment. These qualitative differences could be detected reliably by independent raters, but were not always captured in standard severity scores.Conclusion: Fluctuations occurring in DLB have particular characteristics that are distinguishable from fluctuations occurring in AD. Interpretation and application of the fluctuation criterion continues to limit the diagnostic sensitivity of the consensus criteria for DLB. Findings suggest that explicit documentation and a wider appreciation of these distinctions could improve the reliability with which less experienced clinicians identify this core diagnostic feature in the clinical setting.


Related Articles

  • Neuropsychological performance in Lewy body dementia and Alzheimer's disease. Walker, Zuzana; Allen, Ruth L.; Shergill, Sukhwinder; Katona, Cornelius L. E. // British Journal of Psychiatry;Feb97, Vol. 170, p156 

    Background Lewy body dementia (LBD) is emerging as a common cause of degenerative dementia. However, LBD cannot yet be diagnosed with certainty in life. There is some preliminary evidence that the pattern of cognitive impairment in LBD is different from that in Alzheimer's disease (AD). We set...

  • Not all dementias are the same.  // Cortlandt Forum;3/25/2004, Vol. 17 Issue 3, p15 

    Reports on the differential diagnosis of Alzheimer's disease (AD) in the U.S. Important distinction between AD and dementia with Lewy bodies; Behavioral hallmarks of AD; Medications for AD patients; Treatment protocols.

  • Several forms of dementia exist. Perkins, Chris // New Zealand Doctor;8/25/2004, p22 

    Provides information on the forms of dementia. Alzheimer's disease; Vascular dementia; Dementia with Lewy bodies. INSET: Consensus criteria -- diagnosis of probable DLB.

  • MENTAL HEALTH Dementia. Morris, Mark // Pulse;3/25/2009, Vol. 69 Issue 10, p36 

    The article offers information on the types, diagnosis, and treatment of the condition called dementia. It mentions the different types of dementia, which include Alzheimer's disease, vascular dementia and Lewy body disease. The rare reversible causes of dementia include thyroid disease,...

  • CITATIONS AND CLINICIANS' NOTES: DEMENTIA.  // Current Medical Literature: Neurology;2004, Vol. 20 Issue 1, p21 

    Presents abstracts of articles related to dementia. "Treating the Full Spectrum of Dementia With Memantine," by B. Winblad and V. Jelic; "Current Treatment of Dementia With Lewy Bodies and Dementia Associated With Parkinson's Disease," by D. J. Burn and I. G. McKeith; "Prediction of Poststroke...

  • Dementia. Bain, Peter; Blass, John; Wade, John // Current Medical Literature: Neurology;2006, Vol. 22 Issue 3, p85 

    The article provides information on the results of several studies regarding dementia. Patients with dementia with Lewy bodies and Alzheimer's disease could be differentiated through different patterns of activation and deactivation evidence. A purified cannabis derivative drolabinol is...

  • Incidence and survival of dementia in a general population of Japanese elderly: the Hisayama study. Matsui, Y.; Tanizaki, Y.; Arima, H.; Yonemoto, K.; Doi, Y.; Ninomiya, T.; Sasaki, K.; Iida, M.; Iwaki, T.; Kanba, S.; Kiyohara, Y. // Journal of Neurology, Neurosurgery & Psychiatry;Apr2009, Vol. 80 Issue 4, p366 

    Objective: To estimate the incidence and survival rates of total and cause specific dementia in a general Japanese population. Methods: A total of 828 subjects without dementia, aged 65 years or over, were followed-up prospectively for 17 years. Dementia was subdivided into cause specific...

  • Fully automatic differential diagnosis system for dementia with Lewy bodies and Alzheimer’s disease using FDG-PET and 3D-SSP. Kono, Atsushi K.; Ishii, Kazunari; Sofue, Keitaro; Miyamoto, Naokazu; Sakamoto, Setsu; Mori, Etsuro // European Journal of Nuclear Medicine & Molecular Imaging;Sep2007, Vol. 34 Issue 9, p1490 

    To evaluate a fully automatic computer-assisted diagnostic system for mild dementia with Lewy bodies (DLB), permitting distinction from mild Alzheimer’s disease (AD). Using 18F-fluorodeoxyglucose and positron emission tomography (FDG-PET), glucose metabolic images were obtained from mild...

  • Pathological entity of dementia with Lewy bodies and its differentiation from Alzheimer’s disease. Marui, Wami; Iseki, Eizo; Kato, Masanori; Akatsu, Hiroyasu; Kosaka, Kenji // Acta Neuropathologica;Aug2004, Vol. 108 Issue 2, p121 

    We reclassified the pathological subtypes of dementia with Lewy bodies (DLB), based on both Lewy pathology and Alzheimer pathology, to clarify the pathological entity of DLB and the boundary between DLB and Alzheimer’s disease (AD) in autopsied cases, using both pathological and...


Read the Article


Sign out of this library

Other Topics