What is the clinical prevalence of lewy body dementia?
What is the clinical prevalence of lewy body dementia?
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路易体痴呆的临床患病率是多少？
DOI：
10.1002/gps.930091107
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发表时间：
1994
影响因子：
4
通讯作者：
C. Katona
中科院分区：
文献类型：
--
作者：
S. Shergill;E. Mullan;P. D'ath;C. Katona
据报道，尸检系列中路易体痴呆 (LBD) 的患病率从 12% 到 20% 不等。这样的系列可能无法代表整个痴呆症人群。我们试图确定转诊至地区综合医院并诊断为痴呆症的患者中 LBD 的患病率。使用包含 McKeith 和 Byrne 提出的 LBD 体内诊断标准项目的清单，对一系列临床诊断患者的病例记录进行了分析，这些患者在 1 年期间内由两名老年精神病学顾问进行护理（N = 114）。对符合阿尔茨海默病 ICD 10 标准的亚组 (N = 76) 重复进行了分析。根据 McKeith 标准，LBD 的患病率为 26.3%；根据 Byrne probable 标准，LBD 患病率为 7%；根据 Byrne 可能标准，LBD 患病率为 16.6%。然而，不同标准之间存在相当大的分歧。对满足和不满足 LBD 的受试者中个体临床特征的频率进行了审查。 Logistic 回归分析显示，能够区分 LBD 和其他痴呆症的主要临床特征是： 存在幻视或幻听；锥体外系特征或抗精神病药物敏感性综合征；临床特征在很长一段时间内的波动模式（麦基思标准）；存在经典帕金森病，同时或较早发作痴呆（伯恩标准）。阿尔茨海默病子样本的结果基本相似。因此，很大一部分痴呆症患者转诊至老年精神病学服务机构，符合 LBD 的体内标准。不同标准诊断 LBD 的频率存在差异，表明这些临床标准可能需要修订。
The reported prevalence of Lewy body dementia (LBD) has varied from 12% to 20% in postmortem series. Such series may not be representative of the dementia population as a whole. We have attempted to determine the prevalence of LBD in patients referred to a district general hospital with a diagnosis of dementia. The case notes of a consecutive series of patients with a clinical diagnosis referred to the care of two consultants in old age psychiatry over a period of 1 year (N= 114) were analysed using a checklist incorporating the items of the criteria proposed by McKeith and by Byrne for the in vivo diagnosis of LBD. The analysis was repeated for the subgroup (N = 76) fulfilling ICD 10 criteria for Alzheimer's disease. The prevalence of LBD was 26.3% according to McKeith criteria, 7% according to Byrne probable and 16.6% according to Byrne possible criteria. There were, however, considerable disagreements between different criteria. The frequencies of individual clinical features within subjects fulfilling and not fulfilling LBD were reviewed. Logistic regression analysis revealed the main clinical features capable of differentiation between LBD and other dementias were: presence of visual or auditory hallucinations; extrapyramidal features or neuroleptic sensitivity syndrome; fluctuating pattern of clinical features over a long period of time (McKeith criteria); and presence of classical Parkinsonism with simulataneous or earlier onset of dementia (Byrne criteria). The results were essentially similar in the Alzheimer's disease subsample. A significant proportion of patients with dementia referred to an old age psychiatry service thus fulfil in vivo criteria for LBD. The variation in frequency of diagnosis of LBD by the different criteria suggests that these clinical criteria may need revising.