Motor performance differentiates individuals with Lewy body dementia, Parkinson's and Alzheimer's disease.
INTRODUCTION
Differential diagnosis of dementia with Lewy bodies (DLB), Parkinson's disease with dementia (PDD), Parkinson's disease (PD) and Alzheimer's disease (AD) is challenging. Comparative motor profiles of these neurodegenerative disorders may aid in earlier diagnosis but have not been extensively studied.


METHODS
Groups were rigorously matched by age, education, and sex. DLB/PDD participants were matched by Mini-Mental State Examination Score to individuals with AD and by Unified Parkinson's Disease Rating Scale motor scores to individuals with PD. Gait, balance, dual task walking and hand dexterity measures were compared between a combined group (n=21) of individuals with Lewy body dementia (LBD) consisting of those with DLB (n=11) and PDD (n=10) to individuals with PD (n=21) or AD (n=21).


RESULTS
Individuals at the same disease stage with LBD walked significantly slower with shorter stride lengths (p<0.05), demonstrated poorer balance on both the Tinetti and Berg Balance Scale, and poorer performance on dual-task and figure-of-eight walking compared to PD and AD (p<0.05 for all) groups. Upper extremity coordination on the 9-hole peg test differentiated LBD from both PD and AD and was the only motor test in which individuals with AD performed worse than those with PD. Tinetti balance subscores were significantly lower in PDD compared to DLB participants (10.4±2.3 versus 12.8±2.3; p=0.027).


CONCLUSIONS
Motor features distinguish individuals with LBD from those with AD and PD. Measures of gait, balance and finger dexterity provide an additional means of differentiating individuals with LBD from those with AD and PD.
['Fritz|Nora E|NE|', 'Kegelmeyer|Deborah A|DA|', 'Kloos|Anne D|AD|', 'Linder|Shannon|S|', 'Park|Ariane|A|', 'Kataki|Maria|M|', 'Adeli|Anahita|A|', 'Agrawal|Punit|P|', 'Scharre|Douglas W|DW|', 'Kostyk|Sandra K|SK|']
D000368:Aged D000369:Aged, 80 and over D000544:Alzheimer Disease D003430:Cross-Sectional Studies D003937:Diagnosis, Differential D005260:Female D005684:Gait D006801:Humans D020961:Lewy Body Disease D008297:Male D009048:Motor Skills D010300:Parkinson Disease D004856:Postural Balance
Lewy body Gait Balance Hand dexterity Dual-task assessment Parkinson disease