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Cognitive decline in mild cognitive impairment with Lewy bodies or Alzheimer’s disease: a prospective cohort study

Lookup NU author(s): Dr Calum Hamilton, Professor Fiona Matthews, Dr Paul Donaghy, Professor John-Paul Taylor, Professor John O'Brien, Nicola Barnett, Kirsty Olsen, Dr James Lloyd, Dr George Petrides, Professor Ian McKeith, Professor Alan Thomas

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

Objectives We explored whether the mild cognitive impairment (MCI) stages of dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD) differ in their cognitive profiles, and longitudinal progression. Design A prospective, longitudinal design was utilized with annual follow-up (Max 5 years, Mean 1.9, SD 1.1) after diagnosis. Participants underwent repeated cognitive testing, and review of their clinical diagnosis and symptoms, including evaluation of core features of DLB. Setting This was an observational study of independently-living individuals, recruited from local healthcare trusts in North East England, UK. Participants An MCI cohort (n = 76) aged ≥ 60 years was utilized, differentially diagnosed with MCI due to AD (MCI-AD), or possible/probable MCI with Lewy bodies (MCI-LB). Measurements A comprehensive clinical and neuropsychological testing battery was administered, including ACE-R, trailmaking tests, FAS verbal fluency, and computerized battery of attention and perception tasks. Results Probable MCI-LB presented with less impaired recognition memory than MCI-AD, greater initial impairments in verbal fluency and perception of line orientation, and thereafter demonstrated an expedited decline in visuo-constructional functions in the ACE-R compared to MCI-AD. No clear diagnostic group differences were found in deterioration speeds for global cognition, language, overall memory, attention or other executive functions. Conclusions These findings provide further evidence for differences in severity and decline of visuospatial dysfunctions in DLB compared with AD; further exploration is required to clarify when and how differences in attention, executive, and memory functions emerge, as well as speed of decline to dementia.


Publication metadata

Author(s): Hamilton CA, Matthews FE, Donaghy PC, Taylor JP, O'Brien JT, Barnett N, Olsen K, Lloyd J, Petrides G, McKeith IG, Thomas AJ

Publication type: Article

Publication status: Published

Journal: American Journal of Geriatric Psychiatry

Year: 2021

Volume: 29

Issue: 3

Pages: 272-284

Print publication date: 01/03/2021

Online publication date: 08/08/2020

Acceptance date: 16/07/2020

Date deposited: 06/08/2020

ISSN (print): 1064-7481

ISSN (electronic): 1545-7214

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.jagp.2020.07.018

DOI: 10.1016/j.jagp.2020.07.018


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