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Neuropsychological differentiation between A lzheimer's disease and dementia with L ewy bodies in a memory clinic
Author(s) -
Kawai Yoshinari,
Miura Rina,
Tsujimoto Masashi,
Sakurai Takashi,
Yamaoka Akiko,
Takeda Akinori,
Arahata Yutaka,
Washimi Yukihiko,
Kachi Teruhiko,
Toba Kenji
Publication year - 2013
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/psyg.12019
Subject(s) - memory span , wechsler adult intelligence scale , psychology , raven's progressive matrices , audiology , wechsler memory scale , dementia , neuropsychology , cognition , recall , psychiatry , cognitive psychology , working memory , medicine , disease , pathology
Objective The aim of this study was to identify a useful neuropsychological instrument for making a differential clinical diagnosis between A lzheimer's disease ( AD ) and dementia with L ewy bodies ( DLB ). Methods We examined 402 AD and 38 DLB patients with neuropsychological tests that covered general cognition, frontal lobe cognitive function, non‐verbal abstract reasoning, working memory and attention, and verbal memory. Discriminant analysis using a stepwise method was performed to identify the measures best able to discriminate between AD and DLB . Results The AD patients performed significantly worse than the DLB patients on orientation to time, delayed recall subtests on the M ini‐ M ental S tate E xamination, and logical memory subtests 1 and 2 of the R evised W echsler M emory S cale. The DLB patients performed significantly worse than the AD patients on the attention, repetition, and pentagon copying subtests of the M ini‐ M ental S tate E xamination, the constructional praxis subtests of the A lzheimer's D isease A ssessment S cale‐cognitive component‐ J apanese version, the F rontal A ssessment B attery total score, R aven's C oloured P rogressive M atrices ( RCPM ) sets A , AB , and B , and backward digit span. Discriminant analyses between AD and DLB established the key variables as Logical Memory 1, Logical Memory 2, backward digit span, RCPM , and delayed recall on the M ini‐ M ental S tate E xamination. We inferred the AD–DLB discriminant index from the following discriminant analyses: AD–DLB discriminant index = (Backward digit span score + RCPM set B score) − (Logical Memory 1 score + Logical Memory 2 score), which offered a highly favourable value for diagnostic utility. Conclusions The AD–DLB discriminant index, consisting of backward digit span, RCPM set B , and logical memory 1 and 2, is useful to differentiate between AD and DLB .