© 2002 Journal of Neurology Neurosurgery and Psychiatry
EDITORIAL COMMENTARY
Dementia
Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease
Institute for Ageing and Health, Wolfson Research Centre, Newcastle upon Tyne, UK
Correspondence to:
Correspondence to:
Professor C Ballard, Wolfson Research Centre, Institute for Ageing and Health, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK;
c.g.ballard@newcastle.ac.uk
New approach to assessment of patients with dementia with Lewy bodies is clinically useful in differentiating them from patients with Alzheimer's disease
A ccurate and early clinical diagno sis of dementia with Lewy bodies (DLB) is essential for optimal management so that pitfalls such as severe neuroleptic sensitivity1 can be avoided, a trial of cholinesterase treatment can be instigated,2 and parkinsonian symptoms3 can be appropriately treated, weighing up the balance of psychiatric and motor symptoms and fall risk. In practice it has often been difficult to differentiate DLB from other forms of dementia, particularly Alzheimer's disease. Several previous studies have suggested that DLB and Alzheimer's disease can be differentiated on the basis of visual and visuospatial tasks.4,5 The tasks most easily applicable to initial diagnosis are drawing tests (such as the clock drawing).6 However, this approach ignores what is one of the more striking features of DLB: fluctuating cognition. Operationalised criteria for the clinical diagnosis of DLB (which do consider a broad range of symptoms) have achieved high levels of specificity
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