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Clinical prevalence of Lewy body dementia.


Type

Journal Article

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Authors

Kane, Joseph PM 
Surendranathan, Ajenthan  ORCID logo  https://orcid.org/0000-0003-3809-1545
Bentley, Allison 
Barker, Sally AH 
Taylor, John-Paul 

Abstract

BACKGROUND: The prevalence of dementia with Lewy bodies (DLB) and dementia in Parkinson's disease (PDD) in routine clinical practice is unclear. Prevalence rates observed in clinical and population-based cohorts and neuropathological studies vary greatly. Small sample sizes and methodological factors in these studies limit generalisability to clinical practice. METHODS: We investigated prevalence in a case series across nine secondary care services over an 18-month period, to determine how commonly DLB and PDD cases are diagnosed and reviewed within two regions of the UK. RESULTS: Patients with DLB comprised 4.6% (95% CI 4.0-5.2%) of all dementia cases. DLB was represented in a significantly higher proportion of dementia cases in services in the North East (5.6%) than those in East Anglia (3.3%; χ2 = 13.6, p < 0.01). DLB prevalence in individual services ranged from 2.4 to 5.9%. PDD comprised 9.7% (95% CI 8.3-11.1%) of Parkinson's disease cases. No significant variation in PDD prevalence was observed between regions or between services. CONCLUSIONS: We found that the frequency of clinical diagnosis of DLB varied between geographical regions in the UK, and that the prevalence of both DLB and PDD was much lower than would be expected in this case series, suggesting considerable under-diagnosis of both disorders. The significant variation in DLB diagnostic rates between these two regions may reflect true differences in disease prevalence, but more likely differences in diagnostic practice. The systematic introduction of more standardised diagnostic practice could improve the rates of diagnosis of both conditions.

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Keywords

Dementia in Parkinson’s disease, Dementia with Lewy bodies, Epidemiology, Prevalence, Age of Onset, Aged, Aged, 80 and over, Female, Humans, Incidence, Lewy Body Disease, Male, Parkinson Disease, Prevalence, United Kingdom

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Publisher

Springer Science and Business Media LLC
Sponsorship
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (DTC-RP-PG-0311-12001)