Differentiating Dementia with Lewy Bodies from Alzheimer's Disease Using the Fall Risk Evaluation Questionnaire

• Published in: Internal Medicine Vol. 61; no. 11; pp. 1687 - 1692
• Main Authors: Tsujimoto, Masashi, Suzuki, Keisuke, Takeda, Akinori, Saji, Naoki, Sakurai, Takashi, Washimi, Yukihiko
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.06.2022; Japan Science and Technology Agency
• Subjects: Alzheimer Disease - diagnosis; Alzheimer's disease; Cognitive ability; Cognitive Dysfunction - diagnosis; Dementia; Dementia disorders; Diagnosis, Differential; Environmental changes; falls; Humans; Internal medicine; Lewy bodies; Lewy body disease; Lewy Body Disease - diagnosis; Neurodegenerative diseases; Original; Questionnaires; Surveys and Questionnaires; Lewy body disease; Alzheimer's disease; falls
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8383-21

Objective Dementia with Lewy bodies (DLB) is the second-most common form of neurodegenerative dementia after Alzheimer's disease (AD). Falls are a vital prognostic factor in patients with dementia and are a characteristic feature of DLB. This study investigated the screening potential of the fall risk evaluation for DLB and compared it with that of AD to facilitate an accurate diagnosis. Methods We enrolled patients diagnosed with DLB (n=410) and AD (n=2,683) and categorized the participants into 3 groups depending on their physical ability, age, cognitive function, and fall events. Using the Fall Risk Index-21 (FRI-21) questionnaire, we evaluated and comparatively analyzed the fall risk between DLB and AD patients in three defined groups of participants. Results The FRI-21 score was significantly higher in DLB patients than in AD patients in every group. Using this score, we were able to distinguish between DLB and AD patients in each group. Among the three groups, the group with a young age, relatively mild cognitive dysfunction, and no fall events exhibited the best specificity for DLB (0.895). Conclusions The FRI-21 is a useful tool for screening for DLB and differentiating it from AD. This questionnaire can be used at a relatively early stage of the disease in young patients with mild cognitive dysfunction and no history of falling. These preliminary results need to be validated in an interventional study to evaluate the effectiveness of rehabilitative measures and daily environmental changes carried out to prevent falls using this tool.