Development and Validation of a Screening Questionnaire for Dementia With Lewy Bodies (DLB): the DLB Screening Questionnaire (DLBSQ)
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Purpose: Although dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, its clinical prevalence is low. We developed a short and easy-to-complete DLB screening questionnaire (DLBSQ) to raise diagnostic sensitivity in routine clinical settings. Methods: A total of 501 participants were retrospectively enrolled, including 71 controls, 184 patients without DLB, and 246 patients with probable DLB. All patients underwent clinical evaluation, including core features of DLB, the DLBSQ, brain magnetic resonance imaging, and detailed neuropsychological assessments. The diagnostic performance of the DLBSQ for probable DLB was investigated using a receiver operating characteristic curve analysis. Results: Total DLBSQ score was associated with visuospatial and frontal/executive dysfunction and the diagnosis of probable DLB. The area under the receiver operating characteristic curve for total DLBSQ score was 0.727. Youden’s method revealed an optimal cutoff value of 3. The sensitivity and specificity of the DLBSQ were 68.7% and 62.4%, respectively. Its discriminating performance improved when cognitive test profiles were additionally considered (area under the curve: 0.822, sensitivity: 80.6%, and specificity: 70.4%). Conclusions: The DLBSQ might be a useful screening tool for DLB in routine clinical practice with good sensitivity and specificity.
Abstract
Background and Purpose: Although dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, its clinical prevalence is low. We developed a short and easy-to-complete DLB screening questionnaire (DLBSQ) to raise diagnostic sensitivity in routine clinical settings. Methods: A total of 501 participants were retrospectively enrolled, including 71 controls, 184 patients without DLB, and 246 patients with probable DLB. All patients underwent clinical evaluation, including core features of DLB, the DLBSQ, brain magnetic resonance imaging, and detailed neuropsychological assessments. The diagnostic performance of the DLBSQ for probable DLB was investigated using a receiver operating characteristic curve analysis. Results: Total DLBSQ score was associated with visuospatial and frontal/executive dysfunction and the diagnosis of probable DLB. The area under the receiver operating characteristic curve for total DLBSQ score was 0.727. Youden’s method revealed an optimal cutoff value of 3. The sensitivity and specificity of the DLBSQ were 68.7% and 62.4%, respectively. Its discriminating performance improved when cognitive test profiles were additionally considered (area under the curve: 0.822, sensitivity: 80.6%, and specificity: 70.4%). Conclusions: The DLBSQ might be a useful screening tool for DLB in routine clinical practice with good sensitivity and specificity.
참고문헌 (29)
- Walker Z, "Lewy body dementias", Lancet, 386, pp.1683~1697 (2015)
- Vann Jones SA, "The prevalence and incidence of dementia with Lewy bodies : a systematic review of population and clinical studies", Psychol Med, 44, pp.673~683 (2014)
- Boot B, "The incidence and prevalence of dementia with Lewy bodies is underestimated", Psychol Med, 43, pp.2687~2688 (2013)
- Kane JP, "Clinical prevalence of Lewy body dementia", Alzheimers Res Ther, 10, pp.19~ (2018)
- Jellinger KA, "Prevalence and pathology of dementia with Lewy bodies in the oldest old : a comparison with other dementing disorders", Dement Geriatr Cogn Disord, 31, pp.309~316 (2011)
- Markesbery WR, "Lewy body pathology in normal elderly subjects", J Neuropathol Exp Neurol, 68, pp.816~822 (2009)
- McKeith IG, "Diagnosis and management of dementia with Lewy bodies : fourth consensus report of the DLB Consortium", Neurology, 89, pp.88~100 (2017)
- Ballard C, "The UPDRS scale as a means of identifying extrapyramidal signs in patients suffering from dementia with Lewy bodies", Acta Neurol Scand, 96, pp.366~371 (1997)
- Voss T, "Performance of a shortened Scale for Assessment of Positive Symptoms for Parkinson’s disease psychosis", Parkinsonism Relat Disord, 19, pp.295~299 (2013)
- Mosimann UP, "A semi-structured interview to assess visual hallucinations in older people", Int J Geriatr Psychiatry, 23, pp.712~718 (2008)
- Walker MP, "The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale. Two methods to assess fluctuating confusion in dementia", Br J Psychiatry, 177, pp.252~256 (2000)
- Lee DR, "The dementia cognitive fluctuation scale, a new psychometric test for clinicians to identify cognitive fluctuations in people with dementia", Am J Geriatr Psychiatry, 22, pp.926~935 (2014)
- Postuma RB, "A single-question screen for rapid eye movement sleep behavior disorder : a multicenter validation study", Mov Disord, 27, pp.913~916 (2012)
- Stiasny-Kolster K, "The REM sleep behavior disorder screening questionnaire--a new diagnostic instrument", Mov Disord, 22, pp.2386~2393 (2007)
- Ahn HJ, "Seoul Neuropsychological Screening Battery-dementia version(SNSB-D) : a useful tool for assessing and monitoring cognitive impairments in dementia patients", J Korean Med Sci, 25, pp.1071~1076 (2010)
- Young PN, "Imaging biomarkers in neurodegeneration : current and future practices", Alzheimers Res Ther, 12, pp.49~ (2020)
- Petersen RC, "Mild cognitive impairment as a diagnostic entity", J Intern Med, 256, pp.183~194 (2004)
- McKeith IG, "Research criteria for the diagnosis of prodromal dementia with Lewy bodies", Neurology, 94, pp.743~755 (2020)
- Folstein MF, ""Mini-mental state". A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Jang H, "Prediction model of conversion to dementia risk in subjects with amnestic mild cognitive impairment : a longitudinal, multi-center clinic-based study", J Alzheimers Dis, 60, pp.1579~1587 (2017)
- Ahn IS, "Impairment of instrumental activities of daily living in patients with mild cognitive impairment", Psychiatry Investig, 6, pp.180~184 (2009)
- Won CW, "The validity and reliability of Korean Instrumental Activities of Daily Living(K-IADL)Scale", J Korean Geriatr Soc, 6, pp.273~280 (2002)
- Youden WJ, "Index for rating diagnostic tests", Cancer, 3, pp.32~35 (1950)
- Thomas AJ, "Development of assessment toolkits for improving the diagnosis of the Lewy body dementias : feasibility study within the DIAMOND Lewy study", Int J Geriatr Psychiatry, 32, pp.1280~1304 (2017)
- Galvin JE, "Improving the clinical detection of Lewy body dementia with the Lewy body composite risk score", Alzheimers Dement(Amst), 1, pp.316~324 (2015)
- Kemp J, "Cognitive profile in prodromal dementia with Lewy bodies", Alzheimers Res Ther, 9, pp.19~ (2017)
- Oda H, "Neuropsychological profile of dementia with Lewy bodies", Psychogeriatrics, 9, pp.85~90 (2009)
- McKeith I, "Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study", Lancet Neurol, 6, pp.305~313 (2007)
- Yoshita M, "Diagnostic accuracy of 123I-meta-iodobenzylguanidine myocardial scintigraphy in dementia with Lewy bodies : a multicenter study", PLoS One, 10, pp.e0120540~ (2015)