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Progression to dementia in mild cognitive impairment with Lewy bodies or Alzheimer’s disease

Lookup NU author(s): Dr Calum Hamilton, Professor Fiona MatthewsORCiD, Dr Paul Donaghy, Professor John-Paul TaylorORCiD, Professor John O'Brien, Nicola Barnett, Kirsty OlsenORCiD, Dr Rory Durcan, Dr Gemma RobertsORCiD, Dr Joanna Ciafone, Sally Barker, Dr Michael FirbankORCiD, Professor Ian McKeith, Professor Alan ThomasORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Objective: To determine whether mild cognitive impairment with Lewy bodies or Alzheimer’s disease differ in their rates of clinical progression to dementia, we undertook longitudinal observation of mild cognitive impairment cases with detailed clinical assessment of Lewy body diagnostic characteristics. Methods: Two prospective longitudinal cohorts combining to 111 individuals aged 60 years or older with mild cognitive impairment were assessed annually to track cognitive and clinical progression, including the presence or absence of core clinical features and proposed biomarkers of dementia with Lewy bodies. Multi-state modelling was used to assess the associations of diagnostic characteristics of dementia with Lewy bodies with clinical progression from mild cognitive impairment to dementia, with death as a competing outcome. Results: After a mean follow-up of 2.2 yrs (range = 1-6.7 yrs), 38/111 (34%) of the participants progressed to dementia: 10 with AD, 3 with possible dementia with Lewy bodies and 25 with probable dementia with Lewy bodies. The presence of any Lewy body disease characteristic was associated with an increased hazard of transition to dementia; this risk further increased as more diagnostic characteristics were observed (Hazard ratio = 1.33 per characteristic, 95% CI: 1.11–1.60), and was especially high for those experiencing complex visual hallucinations (Hazard ratio = 1.98, 95% CI: 0.92-4.29) or cognitive fluctuations (Hazard ratio = 3.99, 95% CI: 2.03-7.84). Conclusions: Diagnostic characteristics of Lewy body disease are associated with an increased risk of transition from mild cognitive impairment to dementia.

Publication metadata

Author(s): Hamilton CA, Matthews FE, Donaghy PC, Taylor JP, O'Brien JT, Barnett NA, Olsen K, Durcan R, Roberts G, Ciafone J, Barker S, Firbank MJ, McKeith IG, Thomas AJ

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2021

Volume: 96

Issue: 22

Pages: e2685-e2693

Print publication date: 01/06/2021

Online publication date: 19/04/2021

Acceptance date: 02/03/2021

Date deposited: 03/03/2021

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0000000000012024


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