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J Neuropsychiatry Clin Neurosci 10:405-412, November 1998
© 1998 American Psychiatric Press, Inc.

Lewy Body Disease

Can We Diagnose It?

Michelle Papka, Ph.D., Ana Rubio, M.D., Ph.D., Randolph B. Schiffer, M.D. and Christopher Cox, Ph.D.

Received December 17, 1997; revised March 3, 1998; accepted March 25, 1998. From the Department of Neurology and Alzheimer's Disease Research Center and the Departments of Neurology, Pathology, Laboratory Medicine, Psychiatry, Environmental Medicine, and Biostatistics, University of Rochester Medical Center, Rochester, New York. Address correspondence to Dr. Papka, Department of Neurology, Box 673, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642; e-mail: mpapka{at}mail.neurology.rochester.edu

The authors assessed the accuracy of published clinical criteria and their own modifications of those criteria in diagnosing Lewy body disease (LBD). Clinical diagnoses were made by two clinicians, blinded to neuropathologic diagnoses, using the Rochester Alzheimer's Disease Center database and traditional medical records. Neuropathologic diagnoses were made according to published guidelines. Results from 21 Alzheimer's disease and 18 LBD patients indicated that no set of clinical criteria was accurate in diagnosing LBD. The only significant predictor of LBD in this population was depression, which was more common in LBD than in Alzheimer's disease. The authors conclude that clinical identification of LBD is an important but unresolved neurological problem.

Key Words: Lewy Body Disease • Diagnosis • Alzheimer's Disease • Depression




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