THE CLINICAL-DIAGNOSIS AND MISDIAGNOSIS OF SENILE DEMENTIA OF LEWY BODY TYPE (SDLT)
THE CLINICAL-DIAGNOSIS AND MISDIAGNOSIS OF SENILE DEMENTIA OF LEWY BODY TYPE (SDLT)
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DOI：
10.1192/bjp.165.3.324
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发表时间：
1994-09-01
影响因子：
10.5
通讯作者：
THOMPSON, P
中科院分区：
文献类型：
--
作者：
MCKEITH, IG;FAIRBAIRN, AF;THOMPSON, P
背景。目前的临床分类没有针对路易体型老年痴呆（SDLT）患者的具体诊断分类，该类型最近被认为是老年痴呆的第二大常见神经病理原因。本研究确定了现有临床诊断系统如何标记SDLT患者，并建议如何识别此类患者。对尸检证实的SDLT （n = 20）、阿尔茨海默型痴呆（DAT; n = 21）和多发性梗死性痴呆（MID; n = 9）患者的病例记录应用了一系列痴呆的临床诊断标准。根据神经病理诊断的外部标准计算每组临床标准的预测效度。许多SDLT患者错误地符合MID（35%的Hachinski评分大于或等于7）或DAT（15%的NINCDS“可能的AD”，35%的DSM-III-R数据和50%的NINCDS“可能的AD”）的标准。根据最近公布的具体标准，高达85%的SDLT病例可以被正确识别。SDLT通常具有可识别的临床综合征，现有的临床分类可能需要修改以正确诊断此类患者。
Background. Current clinical classifications do not contain specific diagnostic categories for patients with senile dementia of the Lewy body type (SDLT), recently proposed as the second commonest neuropathological cause of dementia in the elderly. This study determines how existing clinical diagnosis systems label SDLT patients and suggests how such patients may be identified.Method. A range of clinical diagnostic criteria for dementia were applied to case notes of autopsy-confirmed SDLT (n = 20), dementia of Alzheimer type (DAT; n = 21) and multi-infarct dementia (MID; n = 9) patients who had received psychogeriatric assessment. The predictive validity of each set of clinical criteria was calculated against the external criterion of neuropathological diagnosis.Results. Many SDLT patients erroneously met criteria for MID (35% with Hachinski scores greater than or equal to 7) or for DAT (15% by NINCDS 'probable AD', 35% by DSM-III-R DAT and 50% by NINCDS 'possible AD'). Up to 85% of SDLT cases could be correctly identified using recently published specific criteria.Conclusions. SDLT usually has a discernible clinical syndrome and existing clinical classifications may need revision to diagnose correctly such patients.