期刊
JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY
卷 29, 期 5, 页码 249-253出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0891988716656083
关键词
Lewy; diagnosis; criteria; atypical; Alzheimers; delirium
资金
- National Institute for Health Research [ACF-2015-01-010, NF-SI-0611-10048, CL-2016-01-007] Funding Source: researchfish
Efforts to clinically diagnose cases having dementia with Lewy bodies (DLB) identify those with a characteristic clinical syndrome (probable DLB) at the expense of missing an equal, if not greater, number of cases who have atypical presentations thought to be associated with coexisting Alzheimer pathologies. This article argues that further efforts should now be made to characterize this atypical group that constitutes cases previously identified postmortem as the Lewy body variant of Alzheimer disease (AD) or as AD with Lewy bodies. Since such fine distinction is unlikely to be achieved on clinical grounds alone, this new diagnostic category will require robust biomarker validation. Turning to a consideration of early/prodromal diagnosis of both typical and atypical DLB cases, it is suggested that there will be at least 3 prototypical formsa mild cognitive impairment variant, associated with early visuoperceptual and attentional deficits; a delirium onset DLB with provoked or spontaneous delirium as the presenting features; and a psychiatric disorder DLB with its primary presentation as a late-onset affective disorder or psychosis.
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