title: Utility of neuropsychiatric tools in the differential diagnosis of dementia with Lewy bodies and Alzheimer's disease: quantitative and qualitative findings.
abstract: BACKGROUND
  Discerning dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) is one of the most common and challenging differential diagnoses at the memory clinic. Although the neuropsychiatric manifestations have been widely reported as one of the main key points in the differential diagnosis between these two diseases, to date no neuropsychiatric questionnaire has been specifically devised for this purpose.
  
  
  METHODS
  We administered the Neuropsychiatric Inventory (NPI) and the Columbia University Scale for Psychopathology in Alzheimer's Disease (CUSPAD) to a memory clinic sample of 80 patients with probable DLB and 85 age- and severity-matched patients with probable AD. Diagnosis of probable DLB was supported with a positive dopamine transporter SPECT scan. We examined the usefulness of these two neuropsychiatric tools designed for AD in the differential diagnosis between DLB and AD. We also investigated the correlations between psychotic symptoms and measures of cognitive and functional decline.
  
  
  RESULTS
  Auditory hallucinations were very specific of DLB and were usually preceded by visual hallucinations. Misinterpretation of real visual stimuli (illusions) was more frequent in DLB. Delusions were both quantitatively and qualitatively different between DLB and AD: delusional misidentifications were significantly more characteristic of DLB, while paranoid delusions did not show specificity for DLB.
  
  
  CONCLUSIONS
  Neuropsychiatric tools are useful to discriminate DLB from AD. Hallucinations and delusions are not only more frequent in DLB than in AD but also have distinct qualitative characteristics and patterns of progression that can help clinicians to make a more accurate differential diagnosis.
authors.affiliation: Memory Disorders Unit, Department of Neurology, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Aida
authors.initials: A
authors.lastname: Suárez-González
authors.affiliation: Memory Disorders Unit, Department of Neurology, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Serrano-Pozo
authors.affiliation: Department of Psychobiology, University of Salamanca, Salamanca, Spain.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Arroyo-Anlló
authors.affiliation: Memory Disorders Unit, Department of Neurology, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Franco-Macías
authors.affiliation: Department of Public Health and Preventive Medicine, University of Seville, Seville, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Polo
authors.affiliation: Department of Nuclear Medicine, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: David
authors.initials: D
authors.lastname: García-Solís
authors.affiliation: Memory Disorders Unit, Department of Neurology, University Hospital Virgen del Rocío, Seville, Spain.
authors.forename: Eulogio
authors.initials: E
authors.lastname: Gil-Néciga
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D036301:Qualitative Research; D015203:Reproducibility of Results