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Burgio MI, Veronese N, Sarà D, Saccaro C, Masnata R, Vassallo G, Catania A, Catanese G, Mueller C, Smith L, Dominguez LJ, Vernuccio L, Barbagallo M. Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis. Aging Clin Exp Res 2024; 36:60. [PMID: 38451331 PMCID: PMC10920203 DOI: 10.1007/s40520-024-02704-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/17/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Mild cognitive impairment (MCI) may evolve into dementia. Early recognition of possible evolution to Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) is of importance, but actual diagnostic criteria have some limitations. In this systematic review and meta-analysis, we aimed to find the most accurate markers that can discriminate patients with DLB versus AD, in MCI stage. METHODS We searched several databases up to 17 August 2023 including studies comparing markers that may distinguish DLB-MCI from AD-MCI. We reported data regarding sensitivity, specificity, and the area under the curves (AUCs) with their 95% confidence intervals (CIs). RESULTS Among 2219 articles initially screened, eight case-control studies and one cohort study were included for a total of 832 outpatients with MCI. The accuracy of cerebrospinal fluid (CSF) markers was the highest among the markers considered (AUC > 0.90 for the CSF markers), with the AUC of CSF Aβ42/Aβ40 of 0.94. The accuracy for clinical symptom scales was very good (AUC = 0.93), as evaluated in three studies. Although limited to one study, the accuracy of FDG-PET (cingulate island sign ratio) was very good (AUC = 0.95) in discriminating DLB from AD in MCI, while the accuracy of SPECT markers and EEG frequencies was variable. CONCLUSIONS Few studies have assessed the accuracy of biomarkers and clinical tools to distinguish DLB from AD at the MCI stage. While results are promising for CSF markers, FDG-PET and clinical symptoms scales, more studies, particularly with a prospective design, are needed to evaluate their accuracy and clinical usefulness. CLINICAL TRIAL REGISTRATION Prospero (CRD42023422600).
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Affiliation(s)
- Marianna Ilarj Burgio
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Nicola Veronese
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy.
| | - Davide Sarà
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Carlo Saccaro
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Roberta Masnata
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Giusy Vassallo
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Angela Catania
- International School of Advanced Studies, University of Camerino, Camerino, Italy
| | - Giuseppina Catanese
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Christoph Mueller
- South London and Maudsley National Health Service Foundation Trust, London, UK
- Institute of Psychiatry Psychology and Neuroscience, Kings College London, London, UK
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ligia Juliana Dominguez
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
| | - Laura Vernuccio
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Mario Barbagallo
- Department of Health Promotion, Mother Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy
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Morganti W, Veronese N, Barbagelata M, Castagna A, Custodero C, Solimando L, Burgio MI, Montana Lampo SE, Seminerio E, Puleo G, Senesi B, Cammalleri L, Ruotolo G, Sabbà C, Barbagallo M, Pilotto A. Validation of a Brief Form of the Self-Administered Multidimensional Prognostic Index: The SELFY-BRIEF-MPI Project. J Clin Med 2023; 12:6026. [PMID: 37762966 PMCID: PMC10531940 DOI: 10.3390/jcm12186026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed over the past 15 years, it lacks a self-administered and brief version. In this study, we aimed to evaluate the agreement between an abbreviated form of the SELFY-MPI (i.e., SELFY-BRIEF-MPI) and the standard version of the MPI. Four Italian hospitals consecutively enrolled outpatients and inpatients >65 years. The sample included 105 participants (mean age = 78.8 years, 53.3% females). Overall, the two versions showed non-statistically significant differences (Standard-MPI 0.42 ± 0.19 vs.. SELFY-BRIEF-MPI 0.41 ± 0.18; p = 0.104) and a very strong correlation (R = 0.86, p < 0.001). The Bland-Altman Plot revealed that only 5/105 measurements (4.76%) were outside the limits of agreement. The accuracy of the SELFY-BRIEF-MPI in identifying frail people (defined as a Standard-MPI > 0.66) was optimal (area under the curve, AUC = 0.90, p < 0.001). To predict multidimensional frailty, a SELFY-BRIEF-MPI score of 0.60 exhibited the greatest sensitivity/specificity ratio. In conclusion, the SELFY-BRIEF-MPI reported a good agreement with the standard version of the MPI, indicating its application in the screening of multidimensional frailty among older people.
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Affiliation(s)
- Wanda Morganti
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Marina Barbagelata
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Alberto Castagna
- Primary Care Department, Health District of Soverato, Catanzaro Provincial Health Unit, 88068 Soverato, Italy;
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy;
| | - Luisa Solimando
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Marianna Ilarj Burgio
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Sofia Elena Montana Lampo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Emanuele Seminerio
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Gianluca Puleo
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Barbara Senesi
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Lisa Cammalleri
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Giovanni Ruotolo
- Geriatric Medicine Department, Azienda Sanitario Ospedaliero “Renato Dulbecco”, 88100 Catanzaro, Italy;
| | - Carlo Sabbà
- Department of Internal Medicine, and Rare Diseases Centre “C. Frugoni”, University Hospital of Bari, 70120 Bari, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy;
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