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The Clinical Diagnosis and Misdiagnosis of Senile Dementia of Lewy Body Type (SDLT)

Published online by Cambridge University Press:  02 January 2018

I. G. Mckeith ,
A. F. Fairbairn ,
R. H. Perry  and
P. Thompson
I. G. Mckeith*
Affiliation:
MRC Neurochemical Pathology Unit, Brighton Clinic, Newcastle Mental Health (NHS) Trust
A. F. Fairbairn
Affiliation:
University Department of Old Age Psychiatry, Brighton Clinic, Newcastle Mental Health (NHS) Trust
R. H. Perry
Affiliation:
Department of Neuropathology, Newcastle General Hospital, Newcastle upon Tyne
P. Thompson
Affiliation:
Bensham General Hospital, Gateshead, Tyne and Wear
*
Dr McKeith, MRC Neurochemical Pathology Unit, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE
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Abstract

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 ≥ 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

DLT usually has a discernible clinical syndrome and existing clinical classifications may need revision to diagnose correctly such patients.

Information

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue 3 , September 1994 , pp. 324 - 332
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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