The revised Addenbrooke's Cognitive Examination can facilitate differentiation of dementia with Lewy bodies from Alzheimer's disease
Donaghy, Paul C.
Thomas, Alan J.
Rowe, James B.
O'Brien, John T.
International Journal of Geriatric Psychiatry
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Prats‐Sedano, M. A., Savulich, G., Surendranathan, A., Donaghy, P. C., Thomas, A. J., Rowe, J. B., Su, L., & et al. (2020). The revised Addenbrooke's Cognitive Examination can facilitate differentiation of dementia with Lewy bodies from Alzheimer's disease. International Journal of Geriatric Psychiatry, 36 (6), 831-838. https://doi.org/10.1002/gps.5483
Funder: NIHR Cambridge Biomedical Research Centre
Funder: NIHR Newcastle Biomedical Research Centre
Funder: The Lewy Body Society UK
Funder: Cambridge Centre for Parkinson‐Plus Syndromes Wellcome Trust (103838)
Abstract: Objectives: Dementia with Lewy bodies (DLB) is a major cause of degenerative dementia, yet the diagnosis is often missed or mistaken for Alzheimer's disease (AD). We assessed whether the revised Addenbrooke's Cognitive Examination (ACE‐R), a brief test for dementia, differentiates DLB from AD. Methods: We first compared baseline ACE‐R performance in 76 individuals with DLB, 40 individuals with AD and 66 healthy controls. We then investigated the diagnostic accuracy of a simple standardised ‘memory/visuospatial’ ratio calculated from the ACE‐R subscores. Finally, as a comparison a logistic regression machine learning algorithm was trained to classify between DLB and AD. Results: Individuals with AD had poorer memory (p = 0.001) and individuals with DLB had poorer visuospatial function (p = 0.005). Receiver operating characteristics curves confirmed that the ACE‐R total score could differentiate dementia from non‐dementia cases with 98% accuracy, but could not discriminate between dementia types (50%, or chance‐level accuracy). However, a ‘memory/visuospatial’ ratio ≥1.1 differentiated DLB from AD with 82% sensitivity, 68% specificity and 77% mean accuracy. The machine learning classifier did not improve the overall diagnostic accuracy (74%) of the simple ACE‐R subscores ratio. Conclusions: The ACE‐R‐based ‘memory/visuospatial’ ratio, but not total score, demonstrates good clinical utility for the differential diagnosis of DLB from AD.
RESEARCH ARTICLE, RESEARCH ARTICLES, Addenbrooke's Cognitive Examination‐revised, Alzheimer's disease, dementia with Lewy bodies, diagnosis, neurodegeneration, neuropsychology
Alzheimer's Research UK Senior Fellowship (ARUK‐SRF2017B‐1)
External DOI: https://doi.org/10.1002/gps.5483
This record's URL: https://www.repository.cam.ac.uk/handle/1810/321989