Differential diagnosis of degenerative dementias using basic neuropsychological tests: multivariable logistic regression analysis of 301 patients.
BACKGROUND
The validity of neuropsychological tests for the differential diagnosis of degenerative dementias may depend on the clinical context. We constructed a series of logistic models taking into account this factor.


METHODS
We retrospectively analyzed the demographic and neuropsychological data of 301 patients with probable Alzheimer's disease (AD), frontotemporal degeneration (FTLD), or dementia with Lewy bodies (DLB). Nine models were constructed taking into account the diagnostic question (eg, AD vs DLB) and subpopulation (incident vs prevalent).


RESULTS
The AD versus DLB model for all patients, including memory recovery and phonological fluency, was highly accurate (area under the curve = 0.919, sensitivity = 90%, and specificity = 80%). The results were comparable in incident and prevalent cases. The FTLD versus AD and DLB versus FTLD models were both inaccurate.


CONCLUSIONS
The models constructed from basic neuropsychological variables allowed an accurate differential diagnosis of AD versus DLB but not of FTLD versus AD or DLB.
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain ajimenez@ruberinternacional.es.
Adolfo
A
Jiménez-Huete
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
Elena
E
Riva
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
Rafael
R
Toledano
Department of Basic Psychology, Autonoma University of Madrid, Madrid, Spain.
Pablo
P
Campo
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
Jesús
J
Esteban
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
Antonio Del
AD
Barrio
Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
Oriol
O
Franch
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D057174:Frontotemporal Lobar Degeneration / Q000175:diagnosis*; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D012189:Retrospective Studies
Alzheimer disease; Lewy body disease; and logistic models; dementia; demography; diagnosis; differential; frontotemporal lobar degeneration; neuropsychological tests