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Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both.
Neurology. 2005 Jun 28; 64(12):2069-73.Neur

Abstract

OBJECTIVE

To examine the neuropsychological profile of dementia patients from a community-based autopsy sample of dementia, comparing Alzheimer disease (AD), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP).

METHODS

The authors reviewed 135 subjects from a community-based study of dementia for whom autopsy and brain tissue was available. Diagnostic groups were determined according to standard neuropathologic methods and criteria, and the presence of LBs was determined using alpha-synuclein immunostaining. Neuropathologically defined diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neuropsychological test performance at the time of initial study enrollment.

RESULTS

There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), and 22 with LBP alone (LBP alone). There were no significant differences between groups demographically or on performance of enrollment Mini-Mental State Examination (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than the LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) and a naming task (Consortium to Establish a Registry for Alzheimer's Disease Naming; p < 0.05). LBP patients were more impaired than AD patients on executive function (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale-Revised Digit Span; p < 0.05). Decline in MMSE and DRS scores over time were greatest in the patients with AD/LBP.

CONCLUSIONS

In a community-based sample of older, medically complicated patients with dementia, there are neuropsychological differences between dementia subtypes at the time of diagnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy body pathology (LBP) had more severe memory impairment than patients with LBP. LBP alone was associated with more severe executive dysfunction. Patients with AD/LBP had the most rapid rate of cognitive decline.

Authors+Show Affiliations

Mental Illness Research, Education, and Clinical Center, Veterans Administration Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15985574

Citation

Kraybill, M L., et al. "Cognitive Differences in Dementia Patients With Autopsy-verified AD, Lewy Body Pathology, or Both." Neurology, vol. 64, no. 12, 2005, pp. 2069-73.
Kraybill ML, Larson EB, Tsuang DW, et al. Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. Neurology. 2005;64(12):2069-73.
Kraybill, M. L., Larson, E. B., Tsuang, D. W., Teri, L., McCormick, W. C., Bowen, J. D., Kukull, W. A., Leverenz, J. B., & Cherrier, M. M. (2005). Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. Neurology, 64(12), 2069-73.
Kraybill ML, et al. Cognitive Differences in Dementia Patients With Autopsy-verified AD, Lewy Body Pathology, or Both. Neurology. 2005 Jun 28;64(12):2069-73. PubMed PMID: 15985574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. AU - Kraybill,M L, AU - Larson,E B, AU - Tsuang,D W, AU - Teri,L, AU - McCormick,W C, AU - Bowen,J D, AU - Kukull,W A, AU - Leverenz,J B, AU - Cherrier,M M, PY - 2005/6/30/pubmed PY - 2006/1/27/medline PY - 2005/6/30/entrez SP - 2069 EP - 73 JF - Neurology JO - Neurology VL - 64 IS - 12 N2 - OBJECTIVE: To examine the neuropsychological profile of dementia patients from a community-based autopsy sample of dementia, comparing Alzheimer disease (AD), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP). METHODS: The authors reviewed 135 subjects from a community-based study of dementia for whom autopsy and brain tissue was available. Diagnostic groups were determined according to standard neuropathologic methods and criteria, and the presence of LBs was determined using alpha-synuclein immunostaining. Neuropathologically defined diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neuropsychological test performance at the time of initial study enrollment. RESULTS: There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), and 22 with LBP alone (LBP alone). There were no significant differences between groups demographically or on performance of enrollment Mini-Mental State Examination (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than the LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) and a naming task (Consortium to Establish a Registry for Alzheimer's Disease Naming; p < 0.05). LBP patients were more impaired than AD patients on executive function (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale-Revised Digit Span; p < 0.05). Decline in MMSE and DRS scores over time were greatest in the patients with AD/LBP. CONCLUSIONS: In a community-based sample of older, medically complicated patients with dementia, there are neuropsychological differences between dementia subtypes at the time of diagnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy body pathology (LBP) had more severe memory impairment than patients with LBP. LBP alone was associated with more severe executive dysfunction. Patients with AD/LBP had the most rapid rate of cognitive decline. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/15985574/Cognitive_differences_in_dementia_patients_with_autopsy_verified_AD_Lewy_body_pathology_or_both_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=15985574 DB - PRIME DP - Unbound Medicine ER -