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The progression of cognition, psychiatric symptoms, and functional abilities in dementia with Lewy bodies and Alzheimer disease.

Abstract

BACKGROUND

Although dementia with Lewy bodies (DLB) may be one of most common forms of dementia, relatively little is known about its cognitive and functional course.

OBJECTIVE

To compare change over time in general cognitive status, memory test performance, psychiatric symptoms, neurological signs, and functional abilities in patients with probable DLB and probable Alzheimer disease (AD).

DESIGN

Twenty-eight patients who met diagnostic criteria for DLB were recruited into the study from 3 sites. Patients with AD (n = 55) were selected from a larger cohort and matched 2 to 1 to the patients with DLB on age and baseline global cognitive status. Patients were followed up at 6-month intervals for an average of 6.2 visits and assessed at each visit with tests of global cognitive functioning and verbal learning and memory and measures of psychiatric, neurological, and functional status.

RESULTS

At the baseline evaluation, patients with DLB performed more poorly on a measure of constructional praxis and all measures of functional status. They also had more severe psychiatric symptoms and neurological signs than the AD group. Despite these initial differences, generalized estimating equations applied to regression analyses with repeated measures determined that the only difference between the 2 groups in change in cognitive test performance was on a measure of recognition memory; patients with AD declined, while patients with DLB remained relatively stable. Patients with DLB had relatively stable behavioral symptoms and visual illusions, whereas patients with AD had a significant increase in these symptoms over time. Neurological and functional changes over time were similar in the 2 groups.

CONCLUSIONS

Both baseline and longitudinal differences between patients with DLB and patients with AD were noted; these have implications for clinical diagnosis and treatment.

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  • Authors+Show Affiliations

    ,

    Gertrude H. Sergievsky Center and Department of Neurology, Columbia University Medical Center, New York, NY, USA.

    , , , , , , ,

    Source

    Archives of neurology 63:10 2006 Oct pg 1450-6

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Behavioral Symptoms
    Brain
    Cognition Disorders
    Disease Progression
    Female
    Humans
    Lewy Body Disease
    Male
    Memory Disorders
    Neurocognitive Disorders
    Neuropsychological Tests

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17030662

    Citation

    Stavitsky, Karina, et al. "The Progression of Cognition, Psychiatric Symptoms, and Functional Abilities in Dementia With Lewy Bodies and Alzheimer Disease." Archives of Neurology, vol. 63, no. 10, 2006, pp. 1450-6.
    Stavitsky K, Brickman AM, Scarmeas N, et al. The progression of cognition, psychiatric symptoms, and functional abilities in dementia with Lewy bodies and Alzheimer disease. Arch Neurol. 2006;63(10):1450-6.
    Stavitsky, K., Brickman, A. M., Scarmeas, N., Torgan, R. L., Tang, M. X., Albert, M., ... Stern, Y. (2006). The progression of cognition, psychiatric symptoms, and functional abilities in dementia with Lewy bodies and Alzheimer disease. Archives of Neurology, 63(10), pp. 1450-6.
    Stavitsky K, et al. The Progression of Cognition, Psychiatric Symptoms, and Functional Abilities in Dementia With Lewy Bodies and Alzheimer Disease. Arch Neurol. 2006;63(10):1450-6. PubMed PMID: 17030662.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The progression of cognition, psychiatric symptoms, and functional abilities in dementia with Lewy bodies and Alzheimer disease. AU - Stavitsky,Karina, AU - Brickman,Adam M, AU - Scarmeas,Nikolaos, AU - Torgan,Rebecca L, AU - Tang,Ming-Xin, AU - Albert,Marilyn, AU - Brandt,Jason, AU - Blacker,Deborah, AU - Stern,Yaakov, PY - 2006/10/13/pubmed PY - 2006/12/9/medline PY - 2006/10/13/entrez SP - 1450 EP - 6 JF - Archives of neurology JO - Arch. Neurol. VL - 63 IS - 10 N2 - BACKGROUND: Although dementia with Lewy bodies (DLB) may be one of most common forms of dementia, relatively little is known about its cognitive and functional course. OBJECTIVE: To compare change over time in general cognitive status, memory test performance, psychiatric symptoms, neurological signs, and functional abilities in patients with probable DLB and probable Alzheimer disease (AD). DESIGN: Twenty-eight patients who met diagnostic criteria for DLB were recruited into the study from 3 sites. Patients with AD (n = 55) were selected from a larger cohort and matched 2 to 1 to the patients with DLB on age and baseline global cognitive status. Patients were followed up at 6-month intervals for an average of 6.2 visits and assessed at each visit with tests of global cognitive functioning and verbal learning and memory and measures of psychiatric, neurological, and functional status. RESULTS: At the baseline evaluation, patients with DLB performed more poorly on a measure of constructional praxis and all measures of functional status. They also had more severe psychiatric symptoms and neurological signs than the AD group. Despite these initial differences, generalized estimating equations applied to regression analyses with repeated measures determined that the only difference between the 2 groups in change in cognitive test performance was on a measure of recognition memory; patients with AD declined, while patients with DLB remained relatively stable. Patients with DLB had relatively stable behavioral symptoms and visual illusions, whereas patients with AD had a significant increase in these symptoms over time. Neurological and functional changes over time were similar in the 2 groups. CONCLUSIONS: Both baseline and longitudinal differences between patients with DLB and patients with AD were noted; these have implications for clinical diagnosis and treatment. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/17030662/The_progression_of_cognition_psychiatric_symptoms_and_functional_abilities_in_dementia_with_Lewy_bodies_and_Alzheimer_disease_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.63.10.1450 DB - PRIME DP - Unbound Medicine ER -