Clinical characteristics of pathological confirmed prodromal dementia with Lewy bodies.
Alzheimer's disease
Dementia with Lewy bodies
Prodromal
Journal
Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403
Informations de publication
Date de publication:
15 10 2023
15 10 2023
Historique:
received:
04
07
2023
revised:
08
09
2023
accepted:
19
09
2023
pmc-release:
15
10
2024
medline:
26
10
2023
pubmed:
28
9
2023
entrez:
27
9
2023
Statut:
ppublish
Résumé
Misdiagnosis rate of Dementia with Lewy Bodies (DLB) remains high despite being second most common cause of neurodegenerative dementia. To date, understanding of clinical profile of pathologically confirmed prodromal DLB remains limited. The main objective of this study was to describe and compare it with pathologically confirmed Alzheimer's disease (AD). We accessed the National Alzheimer's Coordinating Center database from 2005 to December 2022 data freeze and included 111 and 501 prodromal DLB and AD patients respectively. First visit data was analyzed. Clinician-determined memory impairment is common in prodromal DLB (>70%) but associated with higher risk for AD diagnosis (OR 0.355, p = 0.0003). DLB had a higher proportion of non-amnestic mild cognitive impairment (MCI) diagnoses but statistically insignificance in differentiating the two. Inattention (OR 2.273, p = 0.0015), and neuropsychiatric features, such as visual hallucinations (OR 11.98, p < 0.0001), depressed mood (OR1.709, p = 0.0292), apathy (1.824, p = 0.0345), and night/REM sleep behaviors, are associated with DLB diagnosis. Hallucinations are infrequent (7-11%). Motor symptoms, particularly gait disorders (OR 4.570, p < 0.001), falls (OR3.939, p = 0.0003), tremors (OR2.237, p = 0.0154), slowness (OR3.573, p < 0.0001), and parkinsonism signs (OR2.443, p < 0.0001), are common. 32% showed no parkinsonism during initial presentation. Neuropsychological examination revealed less impaired memory and language but impaired executive function in DLB. In clinical practice, it is important to note that memory symptoms although being higher risk associated with AD diagnosis, are prominent in prodromal DLB. Psychosis is infrequent, and non-amnestic MCI is not necessarily associated with higher risk of DLB diagnosis. A careful clinical approach is key to improve the diagnosis of prodromal DLB.
Identifiants
pubmed: 37757638
pii: S0022-510X(23)00276-9
doi: 10.1016/j.jns.2023.120815
pmc: PMC10591830
mid: NIHMS1935381
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
120815Subventions
Organisme : NIA NIH HHS
ID : P20 AG068053
Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
Organisme : NIA NIH HHS
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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ID : P20 AG068082
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG079280
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG072977
Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
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Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG066514
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG072959
Pays : United States
Informations de copyright
Copyright © 2023 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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