ALBA Screening Instrument (ASI): A brief screening tool for Lewy Body Dementia

Abstract

Background Early detection of neurodegenerative diseases is essential for treatment and proper care of these patients. Screening tools available today are effective for several types of dementia. However, there is no one specific for Lewy Body Dementia (LBD). Objectives The aim of this paper is to present a tool for early detection of LBD, accessible even for non-medical staff. Methods We stratified subjects (MMSE > 20) into four groups: health controls (HC), Mild Cognitive Impairment (MCI), LBD and other dementias (Alzheimer and vascular). All subjects (age range 50–90) were examined with a comprehensive neuropsychological and neuropsychiatric evaluation, as well as neuroimaging to differentiate diagnosis between groups, fulfilling corresponding criteria. Both neurologists and neuropsychologists were blind to the performance on clinical evaluations and ASI, respectively. The sensitivity and specificity of the instrument were determined to differentiate LBD from other groups. Results We evaluated 427 subjects, 91 HC, 140 with MCI and 196 with dementia. In the dementia group, 75 were diagnosed with LBD and 121 with other dementias. ASI total score was 12.7 ± 0.4 for LBD, 2.9 ± 0.2 for HC, 5 ± 0.7 for MCI, and 5.4 ± 2.6 for other causes of dementia. ROC curve analysis showed a sensitivity of 90.7% and a specificity of 93.6% stands, with 9 as the cutoff with better test performance compared against other groups. Conclusion ASI is a brief screening tool for LBD with high sensitivity and specificity and useful even for non-medical staff.