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Development of assessment toolkits for improving the diagnosis of the Lewy body dementias: feasibility study within the DIAMOND Lewy study.

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Peer-reviewed

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Article

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Authors

Thomas, Alan J 
Taylor, John Paul 
McKeith, Ian 
Bamford, Claire 
Burn, David 

Abstract

OBJECTIVE: The Lewy body dementias (LBD, dementia with Lewy bodies and Parkinson's disease dementia) are the second most common cause of neurodegenerative dementia but remain under-recognised, with long delays from initial assessment to diagnosis. Whilst validated instruments have been developed for key symptoms, there is no brief instrument for overall diagnostic assessment suitable for routine practice. We here report the development of such assessment toolkits. METHODS: We developed the LBD assessment toolkits in three stages. First, we conducted a systematic search for brief validated assessments for key symptoms and combined these into draft instruments. Second, we obtained feedback on acceptability and feasibility through two rounds of interviews with our patient and public involvement group. This led to modification of the toolkits. Finally, we piloted the toolkits in a feasibility study in routine dementia and Parkinson's disease services to produce final instruments suitable for routine clinical practice. RESULTS: Eleven clinicians, working in both dementia/memory assessment and Parkinson's disease/movement disorder services, consented to pilot the assessment toolkits and provide feedback on their feasibility. Clinicians worked in routine health service (not academic) settings and piloted the draft toolkits by integrating them into their regular clinical assessments. Feedback obtained informally, by written comments and through qualitative interviews led to modifications and production of final acceptable versions. CONCLUSIONS: We were able to address an important need, the under-diagnosis of LBD, by developing toolkits for improving the recognition and diagnosis of the LBD, which were acceptable to clinicians working in routine dementia and Parkinson's disease services. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons, Ltd.

Description

Keywords

Parkinson's disease dementia, assessment, dementia with Lewy bodies, toolkits, Aged, Cognition Disorders, Eye Movements, Feasibility Studies, Female, Hallucinations, Humans, Lewy Body Disease, Male, Middle Aged, Motor Activity, Movement Disorders, Parkinson Disease, Pilot Projects

Journal Title

Int J Geriatr Psychiatry

Conference Name

Journal ISSN

0885-6230
1099-1166

Volume Title

Publisher

Wiley
Sponsorship
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (DTC-RP-PG-0311-12001)
This study was supported by the NIHR under its Programme Grants for Applied Research programme (DTC-RP-PG-0311-12001); the NIHR Biomedical Research Unit in Lewy Body Dementia and Biomedical Research Centre awarded to Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University; and the NIHR Biomedical Research Unit in Dementia and the Biomedical Research Centre awarded to Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge.