Prodromal Dementia with Lewy Bodies and Prodromal Alzheimer’s Disease: A Comparison of the Cognitive and Clinical Profiles
| Autor: | Dilman Sadiq, Tim Whitfield, Tim Stevens, Zuzana Walker, Sergi G. Costafreda, Lean Lee |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Lewy Body Disease
Male medicine.medical_specialty Pediatrics Prodromal Symptoms Context (language use) Neuropsychological Tests behavioral disciplines and activities REM sleep behavior disorder 03 medical and health sciences 0302 clinical medicine Alzheimer Disease mental disorders medicine Humans Dementia Longitudinal Studies Psychiatry Episodic memory Retrospective Studies Psychiatric Status Rating Scales 030214 geriatrics Dementia with Lewy bodies General Neuroscience Prodromal Stage Memory clinic Neuropsychology General Medicine medicine.disease nervous system diseases Psychiatry and Mental health Clinical Psychology Disease Progression Female Geriatrics and Gerontology Cognition Disorders Psychology human activities 030217 neurology & neurosurgery |
| Zdroj: | Journal of Alzheimer's Disease. 58:463-470 |
| ISSN: | 1875-8908 1387-2877 |
| DOI: | 10.3233/jad-161089 |
| Popis: | BACKGROUND: Dementia must be diagnosed accurately and early in the disease course to allow pathology-specific treatments to be effective. Dementia with Lewy bodies (DLB) is often misdiagnosed as Alzheimer’s disease (AD), especially at the prodromal stage. OBJECTIVE: To compare the clinical and neuropsychological profiles of Mild Cognitive Impairment (MCI) patients who, at follow-up, progressed to AD (retrospectively AD-MCI) or DLB (retrospectively DLB-MCI) or remained MCI. METHODS: This longitudinal study used an unselected sample from a memory clinic database. A total of 1,848 new patients were seen at the memory clinic between 1994–2015. Of these, 560 patients (30%) had an initial diagnosis of MCI and were considered for the study. Inclusion criteria were patients who had a diagnosis of MCI at initial assessment and a minimum of 12 months’ follow-up. RESULTS: Of the 429 MCI patients with follow-up data, 164 (38%) remained MCI, 107 (25%) progressed to AD, and 21 (5%) progressed to DLB. The remainder progressed to alternative diagnoses. At baseline, DLB-MCI patients performed significantly worse on visuospatial function and letter fluency tests than both AD-MCI and stable-MCI groups, and better on episodic memory tests than the AD-MCI group. At baseline, DLB-MCI patients had a significantly higher mean UPDRS score and were more likely to have REM sleep behavior disorder and fluctuating cognition. CONCLUSION: DLB-MCI patients have a specific cognitive and neuropsychiatric profile which should alert clinicians to the possibility of prodromal DLB. This is relevant when considered in the context of early disease-specific therapy. |
| Databáze: | OpenAIRE |
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