Dementia with Lewy bodies: Findings from an international multicentre study

Objectives. To describe the baseline demographic, neuropsychiatric and neur ological data of a large selected clinical sample of patients with dementia with Lewy Bodies (DLB) from an international multicentre trial with rivast igmine. To examine the usefulness of the Consensus Criteria for the diagnos is of DLB in different countries. Methods. Seventeen centres from Spain, the UK and Italy recruited patients diagnosed clinically as probable DLB according to recent Consensus Criteria (McKeith ct al., 1996). A standard clinical protocol including inclusion/e xclusion criteria, collection of demographic and medical data, cognitive (M ini Mental State Examination: MMSE), motor (Unified Parkinson's Disease Rat ing Scale: UPDRS) and neuropsychiatric (Neuropsychiatric Inventory: NPI) ex aminations, was applied after obtaining informed consent. Data were summari sed and compared across countries with uni- and multivariate analyses. Results. One hundred and twenty patients were recruited: 56.7% males, mean (SD) age 73.9 (6.4) pears, range 57-87 years. Sixty percent fulfilled all t hree core diagnostic features of DLB, and 40% only two ('parkinsonism' 92.4 %, 'cognitive fluctuations' 89.1%, 'visual hallucinations' 77.3%). 'Systema tised delusions' (46%) and 'repeated falls' (42%) were the most frequent su pportive diagnostic features. There were no differences across countries in demographic, diagnostic or clinical features. Patients showed a wide range of psychopathology which was weakly correlated with cognitive impairment. Some mild extrapyramidal signs (EPS) were observed in most patients. Conclusions. The Consensus Criteria for DLB can be consistently applied acr oss many different sites for multicentre studies. 'Parkinsonism' and 'cogni tive fluctuations' as core features and 'systematised delusions' and 'repea ted falls' as supportive features are the most frequent diagnostic clues. N europsychiatric disturbances, in particular apathy, delusions, hallucinatio ns and anxiety, and mild symmetric EPS are frequent in DLB and an only rela ted weakly to cognitive impairment. Copyright (C) 2000 John Wiley & Sons, L td.