DCARD checklist: A simple screening tool for Lewy body disease-related early symptoms in memory clinic

Objective

Despite the relatively high prevalence of Lewy body disease (LBD) in over middle-aged people, physicians and patients show poor awareness of early symptoms. We examined the clinical utility of a simple checklist for screening for the early symptoms of LBD.

Methods

We administered a 7-item screening checklist assessing the five representative early symptoms of LBD (dizziness, constipation, anosmia, REM sleep behavior disorder, and depression: the acronym is “DCARD”) to 450 consecutive individuals who visited the memory clinic at our university hospital. The aim of this retrospective study was to evaluate the usefulness of the DCARD checklist in differentiating neurocognitive disorders (NCD) due to LBD (i.e., NCD with Lewy bodies and NCD due to Parkinson's disease) from NCD due to non-LBD (e.g., Alzheimer's disease). We also associated the DCARD score with current depressive symptoms using the 15-item Geriatric Depression Scale (GDS-15).

Results

Fifty-five participants (12.2 %) had a higher DCARD score (≥4 out of 7 points) regardless of the global cognitive level. The subgroup with higher DCARD scores had higher GDS-15 scores than the subgroup with lower DCARD scores (p < 0.001). With a DCARD cut-off score of 3/4, the sensitivity and specificity were 65 % and 95 %, respectively, for diagnosing NCD due to LBDs. Receiver operating characteristic curve analysis showed good discriminatory ability (area under the curve: 0.89).

Conclusions

This simple LBD screening checklist may be useful as a diagnostic tool for the early diagnosis of LBD in memory clinics.

Clinical trial registry: None.