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Prodromal Dementia With Lewy Bodies: Evolution of Symptoms and Predictors of Dementia Onset.

Authors :
Wyman-Chick KA
O'Keefe LR
Weintraub D
Armstrong MJ
Rosenbloom M
Martin PK
Barclay TR
Barrett MJ
Source :
Journal of geriatric psychiatry and neurology [J Geriatr Psychiatry Neurol] 2022 Jul; Vol. 35 (4), pp. 527-534. Date of Electronic Publication: 2021 Jun 11.
Publication Year :
2022

Abstract

Background: Research criteria for prodromal dementia with Lewy bodies (DLB) were published in 2020, but little is known regarding prodromal DLB in clinical settings.<br />Methods: We identified non-demented participants without neurodegenerative disease from the National Alzheimer's Coordinating Center Uniform Data Set who converted to DLB at a subsequent visit. Prevalence of neuropsychiatric and motor symptoms were examined up to 5 years prior to DLB diagnosis.<br />Results: The sample included 116 participants clinically diagnosed with DLB and 348 age and sex-matched (1:3) Healthy Controls. Motor slowing was present in approximately 70% of participants 3 years prior to DLB diagnosis. In the prodromal phase, 50% of DLB participants demonstrated gait disorder, 70% had rigidity, 20% endorsed visual hallucinations, and over 50% of participants endorsed REM sleep behavior disorder. Apathy, depression, and anxiety were common prodromal neuropsychiatric symptoms. The presence of 1+ core clinical features of DLB in combination with apathy, depression, or anxiety resulted in the greatest AUC (0.815; 95% CI: 0.767, 0.865) for distinguishing HC from prodromal DLB 1 year prior to diagnosis. The presence of 2+ core clinical features was also accurate in differentiating between groups (AUC = 0.806; 95% CI: 0.756, 0.855).<br />Conclusion: A wide range of motor, neuropsychiatric and other core clinical symptoms are common in prodromal DLB. A combination of core clinical features, neuropsychiatric symptoms and cognitive impairment can accurately differentiate DLB from normal aging prior to dementia onset.

Details

Language :
English
ISSN :
0891-9887
Volume :
35
Issue :
4
Database :
MEDLINE
Journal :
Journal of geriatric psychiatry and neurology
Publication Type :
Academic Journal
Accession number :
34114509
Full Text :
https://doi.org/10.1177/08919887211023586