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Background and purpose: The establishment of cognitive fluctuations is important when dementia with Lewy bodies (DLB) is suspected but can be especially difficult in the absence of a caregiver who lives with the patient. We examined the possibility of using fluctuating scores on a forward (FDS) and a backward digit span (BDS) test as a marker for cognitive fluctuation. Methods: Patients with DLB (21), other forms of dementia (14 with Alzheimer’s disease, 8 with vascular dementia) and 20 controls were asked to perform an FDS and BDS twice, with an interval of 20 min. Results: Seventy percent of patients with DLB showed evidence of cognitive fluctuations for at least one test, while less than 10% of controls and patients with other dementias did. Evidence of cognitive fluctuations on at least one of both tests classified 83% of patients correctly (i.e. DLB or not), with a sensitivity of 70% and a specificity of 90%. Conclusions: Repeated forward and backward digit span tests seem a valid, short, easy and inexpensive bedside tool to detect cognitive fluctuations in the diagnostic work-up of DLB, even in the absence of a caregiver, which limits the use of questionnaires.

We wanted to explore possible differences in disease presentation, frequency, and age of onset of dementia with Lewy bodies (DLB) between first-generation immigrants (FGI) and patients born in Belgium (PBIB). We conducted a retrospective study on all patients of our Memory Clinic between June 1, 2010 and January 31, 2020. A synucleinopathy was diagnosed in 150 of 2702 patients (5.5%): 91 received a diagnosis of DLB (3.4%). FGI were two times more likely to receive a diagnosis of DLB, due to a higher prevalence in North-Africans and Latin-Americans. Visual hallucinations were less frequent in North-Africans than in other immigrants. FGI were younger than PBIB and reported more often parasomnia. Our data suggest a higher risk for DLB in certain immigrant groups. Especially for North-African patients, a genetic factor can be suspected, namely mutations in Leucine-rich repeat kinase 2 (LRRK2). Memory clinics with a high rate of FGI may provide interesting data and insights into the prevalence of DLB, genetic and environmental differences.

Analyse de l’anxiété, la dépression et l’insomnie en tant que réseau de symptômes et leurs intensités chez les travailleurs hospitaliers après la première vague de COVID-19.

By reviewing the clinical files of 1,058 consecutive newly admitted outpatients of a Brussels-based memory clinic between 2005 and 2012, this study aims to document the demographic and clinical characteristics of European and non-European first generation immigrants. They accounted for 18.6 % of the patients, of which 8.6 % came from outside Europe (mostly from Morocco, Turkey and the Democratic Republic of Congo). Immigrants with AD tended to be younger, and there was a higher proportion of males among non-European ethnic minorities. There was a higher proportion of Parkinson-related cognitive disorders and Lewy Body disease among European immigrants, whereas non-Europeans had more often a psychiatric diagnosis. Even after correction for education, non-European immigrants had lower MMSE scores, and they did report longer delays between first symptoms and diagnosis, although this last difference was not statistically significant. These results suggest that non-European immigrants with cognitive problems consult later.