Dementia with Lewy bodies: findings from an international multicentre study
Identifieur interne : 001C44 ( Main/Exploration ); précédent : 001C43; suivant : 001C45Dementia with Lewy bodies: findings from an international multicentre study
Auteurs : Teodoro Del Ser [Espagne] ; Ian Mckeith [Royaume-Uni] ; Ravi Anand [États-Unis] ; Ana Cicin-Sain [Suisse] ; Roberto Ferrara [Italie] ; René Spiegel [Suisse]Source :
- International Journal of Geriatric Psychiatry [ 0885-6230 ] ; 2000-11.
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Abstract
Objectives. To describe the baseline demographic, neuropsychiatric and neurological data of a large selected clinical sample of patients with dementia with Lewy Bodies (DLB) from an international multicentre trial with rivastigmine. To examine the usefulness of the Consensus Criteria for the diagnosis of DLB in different countries. Methods. Seventeen centres from Spain, the UK and Italy recruited patients diagnosed clinically as probable DLB according to recent Consensus Criteria (McKeith et al., 1996). A standard clinical protocol including inclusion/exclusion criteria, collection of demographic and medical data, cognitive (Mini Mental State Examination: MMSE), motor (Unified Parkinson's Disease Rating Scale: UPDRS) and neuropsychiatric (Neuropsychiatric Inventory: NPI) examinations, was applied after obtaining informed consent. Data were summarised and compared across countries with uni‐ and multivariate analyses. Results. One hundred and twenty patients were recruited: 56.7% males, mean (SD) age 73.9 (6.4) years, range 57 – 87 years. Sixty percent fulfilled all three core diagnostic features of DLB, and 40% only two (‘parkinsonism’ 92.4%, ‘cognitive fluctuations’ 89.1%, ‘visual hallucinations’ 77.3%). ‘Systematised delusions’ (46%) and ‘repeated falls’ (42%) were the most frequent supportive diagnostic features. There were no differences across countries in demographic, diagnostic or clinical features. Patients showed a wide range of psychopathology which was weakly correlated with cognitive impairment. Some mild extrapyramidal signs (EPS) were observed in most patients. Conclusions. The Consensus Criteria for DLB can be consistently applied across many different sites for multicentre studies. ‘Parkinsonism’ and ‘cognitive fluctuations’ as core features and ‘systematised delusions’ and ‘repeated falls’ as supportive features are the most frequent diagnostic clues. Neuropsychiatric disturbances, in particular apathy, delusions, hallucinations and anxiety, and mild symmetric EPS are frequent in DLB and are only related weakly to cognitive impairment. Copyright © 2000 John Wiley & Sons, Ltd.
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DOI: 10.1002/1099-1166(200011)15:11<1034::AID-GPS231>3.0.CO;2-5
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J. Geriat. Psychiatry</title><idno type="ISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2000-11">2000-11</date><biblScope unit="volume">15</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1034">1034</biblScope><biblScope unit="page" to="1045">1045</biblScope></imprint><idno type="ISSN">0885-6230</idno></series><idno type="istex">6C656BA32E7D0BE6E54575EB4D2114F4246DD1C9</idno><idno type="DOI">10.1002/1099-1166(200011)15:11<1034::AID-GPS231>3.0.CO;2-5</idno><idno type="ArticleID">GPS231</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-6230</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>consensus criteria</term><term>dementia with Lewy bodies</term><term>multicentre study</term><term>pharmaceuticals</term><term>rivastigmine</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="fr">Objectives. To describe the baseline demographic, neuropsychiatric and neurological data of a large selected clinical sample of patients with dementia with Lewy Bodies (DLB) from an international multicentre trial with rivastigmine. To examine the usefulness of the Consensus Criteria for the diagnosis of DLB in different countries. Methods. Seventeen centres from Spain, the UK and Italy recruited patients diagnosed clinically as probable DLB according to recent Consensus Criteria (McKeith et al., 1996). A standard clinical protocol including inclusion/exclusion criteria, collection of demographic and medical data, cognitive (Mini Mental State Examination: MMSE), motor (Unified Parkinson's Disease Rating Scale: UPDRS) and neuropsychiatric (Neuropsychiatric Inventory: NPI) examinations, was applied after obtaining informed consent. Data were summarised and compared across countries with uni‐ and multivariate analyses. Results. One hundred and twenty patients were recruited: 56.7% males, mean (SD) age 73.9 (6.4) years, range 57 – 87 years. Sixty percent fulfilled all three core diagnostic features of DLB, and 40% only two (‘parkinsonism’ 92.4%, ‘cognitive fluctuations’ 89.1%, ‘visual hallucinations’ 77.3%). ‘Systematised delusions’ (46%) and ‘repeated falls’ (42%) were the most frequent supportive diagnostic features. There were no differences across countries in demographic, diagnostic or clinical features. Patients showed a wide range of psychopathology which was weakly correlated with cognitive impairment. Some mild extrapyramidal signs (EPS) were observed in most patients. Conclusions. The Consensus Criteria for DLB can be consistently applied across many different sites for multicentre studies. ‘Parkinsonism’ and ‘cognitive fluctuations’ as core features and ‘systematised delusions’ and ‘repeated falls’ as supportive features are the most frequent diagnostic clues. Neuropsychiatric disturbances, in particular apathy, delusions, hallucinations and anxiety, and mild symmetric EPS are frequent in DLB and are only related weakly to cognitive impairment. Copyright © 2000 John Wiley & Sons, Ltd.</div></front></TEI><affiliations><list><country><li>Espagne</li><li>Italie</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Communauté de Madrid</li><li>New Jersey</li></region><settlement><li>Madrid</li></settlement></list><tree><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Del Ser, Teodoro" sort="Del Ser, Teodoro" uniqKey="Del Ser T" first="Teodoro" last="Del Ser">Teodoro Del Ser</name></region></country><country name="Royaume-Uni"><noRegion><name sortKey="Mckeith, Ian" sort="Mckeith, Ian" uniqKey="Mckeith I" first="Ian" last="Mckeith">Ian Mckeith</name></noRegion></country><country name="États-Unis"><region name="New Jersey"><name sortKey="Anand, Ravi" sort="Anand, Ravi" uniqKey="Anand R" first="Ravi" last="Anand">Ravi Anand</name></region></country><country name="Suisse"><noRegion><name sortKey="Cicin Ain, Ana" sort="Cicin Ain, Ana" uniqKey="Cicin Ain A" first="Ana" last="Cicin-Sain">Ana Cicin-Sain</name></noRegion><name sortKey="Spiegel, Rene" sort="Spiegel, Rene" uniqKey="Spiegel R" first="René" last="Spiegel">René Spiegel</name></country><country name="Italie"><noRegion><name sortKey="Ferrara, Roberto" sort="Ferrara, Roberto" uniqKey="Ferrara R" first="Roberto" last="Ferrara">Roberto Ferrara</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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