The revised Addenbrooke's Cognitive Examination can facilitate differentiation of dementia with Lewy bodies from Alzheimer's disease.

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Tytuł:: The revised Addenbrooke's Cognitive Examination can facilitate differentiation of dementia with Lewy bodies from Alzheimer's disease.
Autorzy:: Prats-Sedano MA; Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Savulich G; Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Surendranathan A; Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Donaghy PC; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Thomas AJ; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Rowe JB; Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Su L; Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
O'Brien JT; Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Źródło:: International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2021 Jun; Vol. 36 (6), pp. 831-838. Date of Electronic Publication: 2020 Dec 14.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: Chichester : John Wiley
Original Publication: Chichester, Sussex, England ; [New York] : Wiley, c1986-
MeSH Terms:: Alzheimer Disease*/diagnosis
Lewy Body Disease*/diagnosis
Cognition ; Diagnosis, Differential ; Humans ; Memory ; Neuropsychological Tests
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Grant Information:: MC_UU_00005/12 United Kingdom MRC_ Medical Research Council; 103838 United Kingdom WT_ Wellcome Trust; United Kingdom DH_ Department of Health; MC_U105597119 United Kingdom MRC_ Medical Research Council; United Kingdom WT_ Wellcome Trust
Contributed Indexing:: Keywords: Addenbrooke's Cognitive Examination-revised; Alzheimer's disease; dementia with Lewy bodies; diagnosis; neurodegeneration; neuropsychology
Entry Date(s):: Date Created: 20201204 Date Completed: 20210602 Latest Revision: 20221005
Update Code:: 20240104
PubMed Central ID:: PMC8247047
DOI:: 10.1002/gps.5483
PMID:: 33275793
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Objectives: Dementia with Lewy bodies (DLB) is a major cause of degenerative dementia, yet the diagnosis is often missed or mistaken for Alzheimer's disease (AD). We assessed whether the revised Addenbrooke's Cognitive Examination (ACE-R), a brief test for dementia, differentiates DLB from AD.
Methods: We first compared baseline ACE-R performance in 76 individuals with DLB, 40 individuals with AD and 66 healthy controls. We then investigated the diagnostic accuracy of a simple standardised 'memory/visuospatial' ratio calculated from the ACE-R subscores. Finally, as a comparison a logistic regression machine learning algorithm was trained to classify between DLB and AD.
Results: Individuals with AD had poorer memory (p = 0.001) and individuals with DLB had poorer visuospatial function (p = 0.005). Receiver operating characteristics curves confirmed that the ACE-R total score could differentiate dementia from non-dementia cases with 98% accuracy, but could not discriminate between dementia types (50%, or chance-level accuracy). However, a 'memory/visuospatial' ratio ≥1.1 differentiated DLB from AD with 82% sensitivity, 68% specificity and 77% mean accuracy. The machine learning classifier did not improve the overall diagnostic accuracy (74%) of the simple ACE-R subscores ratio.
Conclusions: The ACE-R-based 'memory/visuospatial' ratio, but not total score, demonstrates good clinical utility for the differential diagnosis of DLB from AD.
(© 2020 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)

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