Abstract for presentation at Australian and New Zealand Association of Neurologists Annual Scientific Meeting 2008

Impact of Changes in the Consensus Diagnostic Criteria for Dementia with Lewy Bodies

  • Prof Glenda Halliday, Prince of Wales Medical Research Institute and University of New South Wales, Australia
  • Ms Amy King, Prince of Wales Medical Research Institute and University of New South Wales, Australia
  • Ms Heather McCann, Prince of Wales Medical Research Institute and University of New South Wales, Australia

    • Objective: To examine the impact of changes in the consensus criteria for the diagnosis of dementia with Lewy bodies (DLB).
    Methods: 195 longitudinally studied autopsy cases with dementia and/or Parkinson's disease (PD) recruited through a regional brain donor program were selected with α-synuclein-positive brainstem Lewy bodies (with or without additional Alzheimer pathology) in the absence of other neuropathologies. Clinicopathological diagnoses were compared using both the new and old criteria for DLB.
    Results: 53% had a high probability of DLB using the new criteria (12% not demented), 26% had a low probability and 21% were excluded due to a high probability of NIA-Reagan Alzheimer's disease (AD). This compares with a lower number (39%) reaching the older criteria for definite DLB, with 32% excluded using this criteria due to having dementia late in the disease course and 29% excluded due to an absence of dementia. Overall only 29 of the original 195 cases selected (15%) met both the new and old DLB criteria. Cases not meeting both DLB criteria largely had either AD (excluded in new criteria) or PD as their dominant clinical syndrome (excluded in old criteria).
    Conclusion: The impact of the new consensus criteria for the diagnosis of DLB is that the clinical cohort identified differs significantly from that identified using the previous criteria. In particular, a proportion of non-demented PD patients reach the new pathological threshold suggestive of a high probability of clinical DLB.

    Conference Organiser - ICMS Pty Ltd