Neurology Department, Brugmann Hospital, Van Gehuchtenplein 4, 1020, Brussels, Belgium.
Geriatrics Department, Brugmann Hospital, Van Gehuchtenplein 4, 1020, Brussels, Belgium.
Acta Neurol Belg. 2023 Jun;123(3):803-806. doi: 10.1007/s13760-023-02260-8. Epub 2023 Apr 4.
The establishment of cognitive fluctuations is important when dementia with Lewy bodies (DLB) is suspected but can be especially difficult in the absence of a caregiver who lives with the patient. We examined the possibility of using fluctuating scores on a forward (FDS) and a backward digit span (BDS) test as a marker for cognitive fluctuation.
Patients with DLB (21), other forms of dementia (14 with Alzheimer's disease, 8 with vascular dementia) and 20 controls were asked to perform an FDS and BDS twice, with an interval of 20 min.
Seventy percent of patients with DLB showed evidence of cognitive fluctuations for at least one test, while less than 10% of controls and patients with other dementias did. Evidence of cognitive fluctuations on at least one of both tests classified 83% of patients correctly (i.e. DLB or not), with a sensitivity of 70% and a specificity of 90%.
Repeated forward and backward digit span tests seem a valid, short, easy and inexpensive bedside tool to detect cognitive fluctuations in the diagnostic work-up of DLB, even in the absence of a caregiver, which limits the use of questionnaires.
当怀疑患者患有路易体痴呆（DLB）时，认知波动的建立很重要，但如果没有与患者同住的照顾者，这可能尤其困难。我们研究了使用正向（FDS）和反向数字跨度（BDS）测试中的波动分数作为认知波动的标记的可能性。
要求 21 名 DLB 患者、14 名阿尔茨海默病患者、8 名血管性痴呆患者和 20 名对照者进行两次 FDS 和 BDS 测试，间隔 20 分钟。
70%的 DLB 患者至少有一项测试显示出认知波动的证据，而对照组和其他痴呆患者中这一比例不到 10%。至少有一项测试的认知波动证据可正确分类 83%的患者（即 DLB 或非 DLB），其敏感性为 70%，特异性为 90%。
重复的正向和反向数字跨度测试似乎是一种有效、简短、简单且经济的床边工具，可用于检测 DLB 诊断过程中的认知波动，即使在没有照顾者的情况下，这限制了问卷的使用。
