McKeith, IG. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the Consortium on DLB International Workshop. J Alzheimers Dis 9(3 Suppl): 417-423

Wolfson Research Centre, Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK.
Journal of Alzheimer's disease: JAD (Impact Factor: 4.15). 02/2006; 9(3 Suppl):417-23.
Source: PubMed


Dementia with Lewy bodies (DLB) was considered to be an uncommon cause of dementia until improved neuropathological staining methods for ubiquitin were developed in the late 1980's. Subsequent recognition that 10-15% of dementia cases in older people were associated with Lewy body pathology led to the publication in 1996 of Consensus clinical and pathological diagnostic criteria for the disorder. These have greatly raised global awareness of DLB and helped to generate a body of knowledge which informs modern clinical management of this pharmacologically sensitive group of patients. They have also enabled important issues surrounding the relationships of DLB with Alzheimer's disease and Parkinson's disease to be addressed and partially resolved. A recent re-evaluation of the Consensus criteria has confirmed many aspects of the original recommendations, supplementing these with suggestions for improved pathological characterisation, clinical detection and management. Virtu-ally unrecognised 20 years ago, DLB could within this decade be one of the best characterised and potentially treatable neurodegenerative disorders of late life.

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    • "A total of 10 patients declined to participate in the study. Participants were recruited sequentially in accordance with DLB diagnostic criteria (McKeith, 2006), and the diagnosis was confirmed by two experienced clinicians (JOB and IGM). Participants and their informants provided written informed consent, and the study was approved by the local NHS Research Ethics Committee. "
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    ABSTRACT: Objective: Sleep problems and depression are common symptoms in dementia with Lewy bodies (DLB), where patients typically experience subjectively poor sleep quality, fatigue and excessive daytime sleepiness. However, whilst sleep disturbances have been linked to depression, this relationship has not received much attention in DLB. The present cross-sectional study addresses this by examining whether depressive symptoms are specifically associated with subjective sleep quality and daytime sleepiness in DLB, and by examining other contributory factors. Methods: DLB patients (n = 32) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the 15-item Geriatric Depression Scale (GDS-15). Motor and cognitive functioning was also assessed. Pearson correlations were used to assess the relationship between GDS-15, ESS and PSQI scores. Results: GDS-15 scores were positively associated with both ESS (r = 0.51, p < 0.01) and PSQI (r = 0.59, p < 0.001) scores. Conclusions: Subjective poor sleep and daytime sleepiness were associated with depressive symptoms in DLB. Given the cross-sectional nature of the present study, the directionality of this relationship cannot be determined, although this association did not appear to be mediated by sleep quality or daytime sleepiness. Nevertheless, these findings have clinical relevance; daytime sleepiness or poor sleep quality might indicate depression in DLB, and subsequent work should examine whether the treatment of depression can reduce excessive daytime sleepiness and improve sleep quality in DLB patients. Alternatively, more rigorous screening for sleep problems in DLB might assist the treatment of depression.
    International Journal of Geriatric Psychiatry 11/2015; DOI:10.1002/gps.4389 · 2.87 Impact Factor
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    • "In addition, magnetic resonance imaging or computed tomography scanning showing either a normal picture or atrophy, no more than one clinically silent infarction , and no more than mild white matter lesion were required for a diagnosis of pure AD. Vascular dementia was diagnosed according to the Alzheimer's Disease Diagnostic and Treatment Center (ADDTC) core criteria [13], frontotemporal dementia according to the McKhann criteria [14] and Lewy body dementia according to the McKeith criteria [15]. A diagnosis of mixed dementia was made when both AD and cerebrovascular disease were considered to contribute to dementia. "
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    ABSTRACT: Objective: To study the association between self-reported sleep disturbances and dementia risk. Methods: Self-reported sleep disturbances and established risk factors for dementia were measured in men at ages 50 (n = 1574) and 70 (n = 1029) years. Dementia incidence was determined by reviewing their patient history between ages 50 and 90 years. In addition, plasma levels of β-amyloid (Aβ) peptides 1-40 and 1-42 were measured at ages 70, 77, and 82 years. Results: Cox regression demonstrated that men with self-reported sleep disturbances had a higher risk of developing dementia (+33%) and Alzheimer's disease (AD, +51%) than men without self-reported sleep disturbances (both P < .05). Binary logistic regression showed the increased risk for both dementia (+114%) and AD (+192%) were highest when sleep disturbance was reported at age 70 years (both P < .001). No group differences were found in Aβ levels. Conclusion: Improving sleep quality may help reduce the neurodegenerative risk in older men.
    Alzheimer's & dementia: the journal of the Alzheimer's Association 09/2015; 11(9):1090-7. DOI:10.1016/j.jalz.2014.08.104 · 12.41 Impact Factor
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    • "SVD was diagnosed in accordance with National Institute of Neurological Disorders and Stroke- Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS- AIREN) criteria (Roman et al., 1993) and imaging criteria proposed by Erkinjuntti (2002). Other types of dementia were diagnosed using McKeith criteria for dementia with Lewy bodies (DLB) (McKeith et al., 1996) and the Lund and Manchester criteria for frontotemporal dementia (FTD) (The Lund and Manchester Groups, 1994). Onset of dementia was marked as the date on which the clinical symptoms and neuropsychological findings first allowed the diagnosis of dementia to be made. "
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    ABSTRACT: Cerebral white matter hyperintensities (WMH) are prevalent incident findings on brain MRI scans among elderly people and have been consistently implicated in cognitive dysfunction. However, differential roles of WMH by region in cognitive function are still unclear. The aim of this study was to ascertain the differential role of regional WMH in predicting progression from mild cognitive impairment (MCI) to different subtypes of dementia. Participants were recruited from the Clinical Research Center for Dementia of South Korea (CREDOS) study. A total of 622 participants with MCI diagnoses at baseline and follow-up evaluations were included for the analysis. Initial MRI scans were rated for WMH on a visual rating scale developed for the CREDOS. Differential effects of regional WMH in predicting incident dementia were evaluated using the Cox proportional hazards model. Of the 622 participants with MCI at baseline, 139 patients (22.3%) converted to all-cause dementia over a median of 14.3 (range 6.0-36.5) months. Severe periventricular WMH (PWMH) predicted incident all-cause dementia (Hazard ratio (HR) 2.22; 95% confidence interval (CI) 1.43-3.43) and Alzheimer's disease (AD) (HR 1.86; 95% CI 1.12-3.07). Subcortical vascular dementia (SVD) was predicted by both PWMH (HR 16.14; 95% CI 1.97-132.06) and DWMH (HR 8.77; 95% CI 1.77-43.49) in more severe form (≥ 10 mm). WMH differentially predict dementia by region and severity. Our findings suggest that PWMH may play an independent role in the pathogenesis of dementia, especially in AD.
    International Psychogeriatrics 07/2015; -1:1-9. DOI:10.1017/S1041610215001076 · 1.93 Impact Factor
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