New Test Simplifies Dementia Diagnosis

Can a doctor’s response to 10 simple questions about a patient’s symptoms indicate within three minutes whether that patient has Lewy body dementia—a diagnosis that typically takes as long as 18 months to make?

A study published in Alzheimer’s & Dementia in September 2015 suggests it’s possible. Lewy body dementia is a progressive neurological disorder whose symptoms include hallucinations, movement difficulties similar to those of Parkinson’s disease, sleep disturbances such as acting out dreams, and acute episodes of both drowsiness and worsened cognition.

It has traditionally been a challenge to diagnose because no standard methodology exists to help assess symptoms in clinical practice. Doctors who don’t regularly deal with dementia may be unfamiliar with Lewy body dementia, leading to multiple referrals and tests before an accurate diagnosis is made.

Lewy body dementia and Alzheimer’s

Lewy body dementia is often confused with Alzheimer’s disease because both conditions have similar symptoms in their early stages. A delay in the correct diagnosis can expose patients to certain drugs used to treat Alzheimer’s. Lewy body dementia patients are extremely sensitive to these drugs, which could cause serious adverse effects.

The new questionnaire, developed by a neurologist at Florida Atlantic University, promises to simplify diagnosis by attributing scores to signs and symptoms common to Lewy body dementia, such as slow or rigid movements, staring spells or blank looks, tremors when at rest, excessive daytime sleepiness, loss of balance, and incoherent thinking or random thoughts.

More than 250 patients ranging in age from 50 to 98 years old took part in a study to test the questionnaire’s accuracy. The participants underwent a series of comprehensive evaluations, and the researchers surveyed their caregivers. After referring to the evaluation and survey results, researchers addressed 10 questions on the Lewy body composite risk score and quickly assessed whether symptoms were highly associated with Lewy body dementia.

The test correctly distinguished between Lewy body dementia and Alzheimer’s disease nearly 98 percent of the time. The questionnaire also helped doctors diagnose another form of Lewy body dementia called Parkinson’s disease dementia.

Most patients never see a neurologist who specializes in diagnosing Lewy body dementia, so this scoring system enables other practitioners to diagnose Lewy body dementia more accurately.

Besides reducing the risk of potentially harmful drugs of no benefit to patients, recognizing Lewy body dementia early can allow doctors to prescribe therapies to relieve symptoms sooner, when they’re likely to be more effective, and help patients enter clinical trials expressly for their diagnosis without delay.

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HealthAfter50 was published by the University of California, Berkeley, School of Public Health, providing up-to-date, evidence-based research and expert advice on the prevention, diagnosis, and treatment of a wide range of health conditions affecting adults in middle age and beyond. It was previously part of Remedy Health Media's network of digital and print publications, which also include HealthCentral; HIV/AIDS resources The Body and The Body Pro; the UC Berkeley Wellness Letter; and the Berkeley Wellness website. All content from HA50 merged into in 2018.