Lewy Body Composite Risk Score

Lewy body disease has been hard for doctors to diagnose, and people with LBD have frequently been misdiagnosed as having Alzheimer's disease. Now, a 3-minute test has been devised that seems to be accurate in determining if Lewy bodies are involved in the dementia. The test is known as the Lewy Body Composite Risk Score (LBCRS). It was developed by Dr. James E. Galvin, a professor of clinical biomedical science at Florida Atlantic University's Charles E. Schmidt College of Medicine. (The test was published in October 2015, but we just found out about it.)

There is general agreement on the symptoms of LBD. What the LBCRS does is to operationalize those symptoms, giving doctors a simple rating scale to allow diagnosis of LBD. The LBCRS was tested on 256 patients. It was relatively accurate in distinguishing cases of LBD from Alzheimer's disease, and cases of mild cognitive impairment due to LBD from mild cognitive impairment due to Alzheimer's disease.

The LBCRS consists of 10 questions, four of which are related to motor symptoms and four of which are non-motor. The doctor assesses the presence of the symptoms over a 6-month period by examining the patient and talking to the caregiver.

The 10 questions from the LBCRS:

• Have slowness in initiating and maintaining movement or have frequent hesitations or pauses during movement?
• Have rigidity (with or without cogwheeling) on passive range of motion in any of the 4 extremities?
• Have a loss of postural stability (balance) with or without frequent falls?
• Have a tremor at rest in any of the 4 extremities or head?
• Have excessive daytime sleepiness and/or seem drowsy and lethargic when awake?
• Have episodes of illogical thinking or incoherent, random thoughts?
• Have frequent staring spells or periods of blank looks?
• Have visual hallucinations (see things not really there)?
• Appear to act out his/her dreams (kick, punch, thrash, shout or scream)?
• Have orthostatic hypotension or other signs of autonomic insufficiency?

A score of 3 or greater indicates LBD.

You can read the press release from Florida Atlantic University, an article about the LBCRS, and the abstract of the scientific article. The LBCRS is available online.