Author: Hriday Bhambhvani
Institution: University of Alabama at Birmingham
Though not quite a household name, Lewy Body disease (LBD) is the second most common neurodegenerative disease behind Alzheimer’s. LBD affects roughly 1.4 individuals and their families in the United States. Patients experience loss of mobility, cognitive decline, and visual hallucinations. Because LBD symptoms can resemble other forms of dementia, it is currently widely underdiagnosed.
Dr. James Galvin of Florida Atlantic University has developed a survey, the Lewy Body Composite Risk Score (LBCRS), to quickly and accurately diagnosis both LBD and Parkinson’s Disease dementia in about three minutes. The survey is a rating scale that is used to evaluate clinical signs and symptoms associated with LBD. The survey is both simple and succinct – one page long – and includes yes/no questions for six features that are typically in patients with LBD, but not commonly found in other dementias.
The study, “Improving the Clinical Detection of Lewy Body Dementia with the Lewy Body Composite Risk Score,” was recently published in Alzheimer’s and Dementia. Dr. Galvin, lead author, evaluated 256 patients from NYI Medical Center according to LBCRS in an office visit. The LBCRS incorporates a variety of factors, including clinical dementia rating (the canonical scale to quantify severity of dementia), mood, neuropsychological tests, caregiver ratings of behavior and function, and caregiver burden. The LBCRS was able to differentiate between individuals with Alzheimer’s disease and LBD with 96.8 percent accuracy.
According to Dr. Galvin, “Most patients never receive an evaluation by a neurologist skilled in the diagnosis of Lewy Body dementia, and significant delays and misdiagnoses occur in most patients with this disease. This new tool has the potential to provide a clearer, more accurate picture for those patients who are unable to be seen by specialists, hastening the correct diagnosis and reducing the strain and burden placed on patients and caregivers."
High sensitivity is another improvement of the LBCRS in comparison to prior diagnostic measures. Sensitivity refers to the rate at which a test will be positive for an individual with disease. In other words, if a test is highly sensitive and the test result is negative, the clinician can be almost certain the patient doesn’t have the disease in question. Increased sensitivity also reduces the risk of exposure to certain medications that may have adverse consequences. The LBCRS was found to have a sensitivity of 90%.
In conclusion, the LBCRS has the potential to become an effective clinical tool to improve detection of LBD. Specifically, early detection of LBD opens doors to treatments at the earliest stages when they are the most potent.