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The clinical diagnosis and misdiagnosis of senile dementia of Lewy body type (SDLT)

Lookup NU author(s): Professor Ian McKeith, Dr Andrew Fairbairn, Emeritus Professor Robert Perry

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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 greater than or equal to 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. SDLT usually has a discernible clinical syndrome and existing clinical classifications may need revision to diagnose correctly such patients.

Publication metadata

Author(s): McKeith IG, Fairbairn AF, Perry RH, Thompson P

Publication type: Article

Publication status: Published

Journal: British Journal of Psychiatry

Year: 1994

Volume: 165

Pages: 324-332

Print publication date: 01/09/1994

ISSN (print): 0007-1250

ISSN (electronic): 1472-1465

Publisher: Royal College of Psychiatrists

URL: http://dx.doi.org/10.1192/bjp.165.3.324

DOI: 10.1192/bjp.165.3.324

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