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Journal of Geriatric Psychiatry and Neurology, Vol. 16, No. 4, 245-250 (2003)
DOI: 10.1177/0891988703258671
© 2003 SAGE Publications

Can Alzheimer’s Disease and Dementias with Lewy Bodies be Distinguished Clinically?

Myron F. Weiner, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Neurology, the Department of Psychiatrymyron.weiner{at}utsouthwestern.edu

Linda S. Hynan, PhD

University of Texas Southwestern Medical Center, Dallas, Academic Computing Services,the Department of Psychiatry

Bhavin Parikh, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Psychiatry

Nasir Zaki, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Psychiatry

Charles L. White, III, MD

University of Texas Southwestern Medical Center, Dallas, Department of Pathology

Eileen H. Bigio, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois

Anne M. Lipton, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Neurology, the Department of Psychiatry

Kristin Martin-Cook, MS

University of Texas Southwestern Medical Center, Dallas, the Department of Psychiatry

Doris A. Svetlik, RN, MS

University of Texas Southwestern Medical Center, Dallas, the Department of Psychiatry

C. Munro Cullum, PhD

University of Texas Southwestern Medical Center, Dallas, the Department of Neurology,the Department of Psychiatry

Steven Vobach, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Psychiatry

Roger N. Rosenberg, MD

University of Texas Southwestern Medical Center, Dallas, the Department of Neurology

To determine if Alzheimer’s disease (AD), its Lewy body (LB) variant (LBV), and diffuse LB disease (DLBD) are distinguishable at initial clinical evaluation, data from autopsy-confirmed AD, LBV, and DLBD were examined. No significant differences were found in age at onset, age at death, total duration of illness, duration of illness before initial visit, duration of illness from initial visit to death, or severity of illness at initial evaluation. Hallucinations and delusions were significantly more frequent for LBV and DLBD, respectively, than for AD, and falls were more frequent for DLBD than for AD. Extrapyramidal symptoms (EPS) were less frequent in neuroleptic-free AD subjects than in LB subjects; the percentage of AD patients with EPS after neuroleptic exposure was less than that among LB patients. Seizures were significantly more common for DLBD than for AD or LBV. LB dementias differed from AD at initial evaluation, with more frequent hallucinations and delusions, EPSs, and seizures, and longitudinally in neuroleptic sensitivity, but the data did not distinguish LBV from DLBD.

Key Words: Alzheimer • Lewy body • diagnosis


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