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BMJ Open 2:e000380 doi:10.1136/bmjopen-2011-000380
  • Neurology
    • Research

Comparison of cognitive decline between dementia with Lewy bodies and Alzheimer's disease: a cohort study

  1. John O'Brien3
  1. 1Research Department of Mental Health Sciences, University College London, Bloomsbury Campus, London, UK
  2. 2North Essex Partnership Foundation NHS Trust, Essex, UK
  3. 3Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
  4. 4Institute of Psychiatry, Ain Shams University, Cairo, Egypt
  5. 5Department of Nuclear Medicine, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
  6. 6Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, Netherlands
  7. 7Centre Anoine Lacassagne Department of Nuclear Medicine, Medical Faculty, University of Nice Sophia-Antipolis, Nice, France
  1. Correspondence to Dr Zuzana Walker; z.walker{at}ucl.ac.uk
  • Received 5 October 2011
  • Accepted 16 December 2011
  • Published 8 February 2012

Abstract

Objectives Dementia with Lewy bodies (DLB) accounts for 10%–15% of dementia cases at autopsy and has distinct clinical features associated with earlier institutionalisation and a higher level of carer distress than are seen in Alzheimer's disease (AD). At present, there is on-going debate as to whether DLB is associated with a more rapid cognitive decline than AD. An understanding of the rate of decline of cognitive and non-cognitive symptoms in DLB may help patients and carers to plan for the future.

Design In this cohort study, the authors compared 100 AD and 58 DLB subjects at baseline and at 12-month follow-up on cognitive and neuropsychiatric measures.

Setting Patients were recruited from 40 European centres.

Participants Subjects with mild–moderate dementia. Diagnosis of DLB or AD required agreement between consensus panel clinical diagnosis and visual rating of 123I-FP-CIT (dopamine transporter) single photon emission computed tomography neuroimaging.

Outcome measures The Cambridge Cognitive Examination including Mini-Mental State Examination and Neuropsychiatric Inventory (NPI).

Results The AD and DLB groups did not differ at baseline in terms of age, gender, Clinical Dementia Rating score and use of cholinesterase inhibitors or memantine. NPI and NPI carer distress scores were statistically significantly higher for DLB subjects at baseline and at follow-up, and there were no differences between AD and DLB in cognitive scores at baseline or at follow-up. There was no significant difference in rate of progression of any of the variables analysed.

Conclusions DLB subjects had more neuropsychiatric features at baseline and at follow-up than AD, but the authors did not find any statistically significant difference in rate of progression between the mild–moderate AD and DLB groups on cognitive or neuropsychiatric measures over a 12-month follow-up period.

Footnotes

  • Author disclosure statements At the time of the study, ZW, JOB, IM, KT, JB and JD have received consultancy payments from GE Healthcare. JR has received funding for neuroimaging research from GE Healthcare. TQ has no disclosures.

  • To cite: Walker Z, McKeith I, Rodda J, et al. Comparison of cognitive decline between dementia with Lewy bodies and Alzheimer's disease: a cohort study. BMJ Open 2012;2:e000380. doi:10.1136/bmjopen-2011-000380

  • Contributors ZW: involved in conception and design of the study as well as being a member of the consensus panel, contributed to statistical analysis and interpretation, co-wrote initial draft of the manuscript and prepared the final version of the manuscript; IM: involved in conception and design of the study as well as being a member of the consensus panel, contributed to and approved the final version of the manuscript; JR: involved in conception and design of the study, contributed to data analysis and interpretation, co-wrote initial and subsequent drafts of the manuscript, contributed to and approved the final version of the manuscript; TQ: involved in conception and design of the study, data processing, analysis and interpretation, contributed to and approved the final version of the manuscript; KT: involved in conception and design of the study, performed the visual analysis of the SPECT data, contributed to and approved the final version of the manuscript; JB: involved in conception and design of the study, performed the visual analysis of the SPECT data, contributed to and approved the final version of the manuscript; JD: involved in conception and design of the study, performed the visual analysis of the SPECT data, contributed to and approved the final version of the manuscript; JOB: involved in conception and design of the study as well as being a member of the consensus panel, contributed to and approved the final version of the manuscript.

  • Funding The data collection was sponsored by GE Healthcare who made data available for further analysis for the present study.

  • Competing interests None.

  • Ethics approval Ethical approval in 20 countries obtained (various).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data used in this study were supplied by, and remain the property of, GE Healthcare. Hence, these are not available for sharing.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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